超声引导下肌间沟臂丛神经阻滞联合颈浅丛神经阻滞在锁骨骨折术中的应用效果  

Application effect of ultrasound-guided interscalene brachial plexus block combined with superficial cervical plexus block in clavicle fracture surgery

作　　者：胡灼军 王彬彬 李汝琳 李杰[2] HU Zhuojun;WANG Binbin;LI Rulin;LI Jie(Anesthesiology Department,Yantai Zhifu Hospital,Yantai 264000;Anesthesiology Department,Yantai Yuhuangding Hospital,Yantai 264000,China)

机构地区：[1]烟台芝罘医院麻醉科,山东烟台264000 [2]烟台毓璜顶医院麻醉科,山东烟台264000

出　　处：《临床医学研究与实践》2023年第13期78-81,共4页Clinical Research and Practice

摘　　要：目的探讨超声引导下肌间沟臂丛神经阻滞联合颈浅丛神经阻滞在锁骨骨折术中的应用效果。方法选择我院2021年1月至12月收治的70例锁骨骨折手术患者作为研究对象,经随机数字表法将其分为观察组和对照组,各35例。观察组采用超声引导下肌间沟臂丛神经阻滞联合颈浅丛神经阻滞方案,对照组采用超声引导下肌间沟臂丛神经阻滞方案。比较两组的麻醉效果。结果麻醉前,两组的心率(HR)、收缩压(SBP)、舒张压(DBP)比较,差异无统计学意义(P>0.05);剥离骨膜时、手术结束时、术后10 min,观察组的HR、SBP、DBP低于对照组,差异具有统计学意义(P<0.05)。观察组的麻醉操作时间、起效时间、痛觉消失时间短于对照组,镇痛维持时间长于对照组,差异具有统计学意义(P<0.05)。术前,两组的促肾上腺皮质激素(ACTH)、皮质醇(Cor)水平比较,差异无统计学意义(P>0.05);骨折复位时,观察组的ACTH、Cor水平均低于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率为2.86%,显著低于对照组的17.14%,差异具有统计学意义(P<0.05)。结论超声引导下肌间沟臂丛神经阻滞联合颈浅丛神经阻滞方案应用于锁骨骨折手术中,具有麻醉起效迅速、镇痛时间长等优势,且安全性高。Objective To investigate the application effect of ultrasound-guided interscalene brachial plexus block combined with superficial cervical plexus block in clavicular fracture surgery.Methods A total of 70 patients undergoing clavicular fracture surgery admitted in our hospital from January to December 2021 were selected as the research objects.The patients were divided into observation group and control group by random number table method,with 35 cases in each group.The observation group received ultrasound-guided interscalene brachial plexus block combined with superficial cervical plexus block scheme,and the control group received ultrasound-guided interscalene brachial plexus block scheme.The anesthetic effects of the two groups were compared.Results Before anesthesia,there were no statistically significant differences in heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure(DBP)between the two groups(P>0.05);at the time of periosteal detachment,end of surgery,and 10 min after surgery,the HR,SBP and DBP of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The anesthesia operation time,onset time,pain relief time of the observation group were shorter than those of the control group,and the analgesic maintenance time was longer than that of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in the levels of adrenocorticotropic hormone(ACTH)and cortisol(Cor)between the two groups(P>0.05);during fracture reduction,the ACTH and Cor levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 2.86%,which was significantly lower than 17.14%in the control group,the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided interscalene brachial plexus block combined with superficial cervic

关 键 词：超声 肌间沟臂丛神经阻滞 颈浅丛神经阻滞 锁骨骨折 

分 类 号：R614[医药卫生—麻醉学]