超声引导下一点法肌间沟臂丛联合锁骨上神经阻滞在锁骨手术中的应用效果  

Application Effect of Ultrasound-guided One-point Method in Brachial Plexus Combined with Supraclavicular Nerve Block in Clavicle Surgery

作　　者：邱晨 宫庆娟[1] QIU Chen;GONG Qingjuan(Department of Pain,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province,510260 China)

机构地区：[1]广州医科大学附属第二医院疼痛科,广东广州510260

出　　处：《世界复合医学》2022年第7期82-84,96,共4页World Journal of Complex Medicine

摘　　要：目的研究超声引导下一点法肌间沟臂丛联合锁骨上神经阻滞在锁骨手术中的应用价值。方法将广州医科大学附属第二医院2020年6月—2021年2月接受锁骨骨折切开复位内固定手术治疗的患者80例纳入研究,以电脑随机数表法将其分为观察组40例和对照组40例。对照组采用超声引导下肌间沟臂丛联合颈浅丛神经阻滞,观察组采用超声引导下一点法肌间沟臂丛联合锁骨上神经阻滞。分析两组操作时间、感觉阻滞起效时间、镇痛持续时间,不同时间点疼痛情况,并发症发生情况以及追加镇痛药物情况的差异。结果观察组操作时间(2.80±0.79)min、感觉阻滞起效时间(2.19±0.40)min明显短于对照组,镇痛持续时间(619.33±237.74)min显著长于对照组,差异有统计学意义(t=-3.717、-7.060、3.106,P<0.05)。观察组剥离骨膜、复位固定时的VAS评分均明显低于对照组,差异有统计学意义(P<0.05)。两组各项并发症发生率、追加镇痛药物率对比,差异无统计学意义(P>0.05)。结论超声引导下一点法肌间沟臂丛联合锁骨上神经阻滞在锁骨手术中的应用效果显著,且安全性较高。Objective To study the application value of ultrasound-guided one-point method of brachial plexus in intermuscular groove com⁃bined with supraclavicular nerve block in clavicle surgery.Methods A total of 80 patients who underwent open reduction and internal fixation for clavicle fractures in the Second Affiliated Hospital of Guangzhou Medical University from June 2020 to February 2021 were included in the study,and they were divided into an observation group of 40 cases and a control group of 40 cases by computer random number table method.The control group received ultrasound-guided brachial plexus combined with superficial cervical plexus block under ultrasound guidance,and the observation group received ultrasound-guided one-point method of brachial plexus combined with supraclavicular nerve block.Differences in operation time,onset time of sensory block,duration of analgesia,pain at different time points,complications and addi⁃tional analgesic drugs were analyzed between the two groups.Results The operation time(2.80±0.79)min and the onset time of sensory block(2.19±0.40)min in the observation group were significantly shorter than those in the control group,and the duration of analgesia(619.33±237.74)min was significantly longer than that in the control group,and the difference was statistically significant(t=-3.717,-7.060,3.106,P<0.05).The VAS scores of the observation group at the time of periosteum stripping and reduction and fixation were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the inci⁃dence of various complications and the rate of additional analgesics between the two groups(P>0.05).Conclusion Ultrasound-guided onepoint method of intermuscular groove brachial plexus combined with supraclavicular nerve block in clavicle surgery has a significant effect and high safety.

关 键 词：锁骨手术 超声引导 肌间沟臂丛阻滞 镇痛效果 锁骨上神经 

分 类 号：R614[医药卫生—麻醉学]