锁骨骨折内固定术中超声指引下阻滞颈神经的镇痛效果观察  

Effect of ultrasound-guided cervical nerve block on postoperative pain and hemodynamics in patients with clavicle fracture

作　　者：刘毅 徐敏 Liu Yi;Xu Min(Department of Ultrasound Imaging,Yangtze River Shipping General Hospital,Wuhan 430000,China)

机构地区：[1]长江航运总医院超声影像科,武汉430000

出　　处：《中国医师进修杂志》2024年第12期1112-1115,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨锁骨骨折内固定术中超声指引下阻滞颈神经对患者术后疼痛、血流动力学的影响。方法回顾性选择2021年2月至2023年2月在长江航运总医院手术治疗的锁骨骨折患者140例,按术中采用麻醉方法的不同分为两组,对照组(70例)在超声指引下阻滞臂丛神经,超声指引组(70例)在对照组的基础上给予超声指引下阻滞颈神经,比较两组术中血流动力学参数、麻醉阻滞优良率、痛觉消失时间、术后视觉模拟量表(VAS)、风险事件总发生率。结果超声指引组切皮时(T_(1))、复位骨折时(T_(2))、结束手术时(T_(3))时收缩压、舒张压、心率低于对照组,差异有统计学意义(P<0.05)。超声指引组麻醉阻滞优良率高于对照组[98.57%(69/70)比85.71%(60/70)],差异有统计学意义(χ^(2)=6.31,P<0.05)。超声指引组痛觉消失时间短于对照组[(6.18±1.52)min比(8.95±2.47)min],差异有统计学意义(t=7.99,P<0.05)。超声指引组术后3、6、12、24 h VAS评分低于对照组,差异有统计学意义(P<0.05)。两组风险事件总发生率比较差异无统计学意义(P>0.05)。结论锁骨骨折内固定术采用超声指引下阻滞臂丛神经、颈神经,可稳定患者术中血流动力学参数,提高麻醉阻滞优良率,降低术后疼痛程度,且风险事件发生率较低。ObjectiveTo analyze the effect of ultrasound-guided cervical nerve block on postoperative pain and hemodynamics in patients with clavicle fracture.MethodsA total of 140 patients with clavicle fracture who were surgically treated in Yangtze River Shipping General Hospital from February 2021 to February 2023 were retrospectively selected and divided into two groups according to different anesthesia methods.The control group(70 cases)received ultrasound guidance to block brachial plexus nerve,while the ultrasound guidance group(70 cases)received ultrasound guidance to block cervical nerve on the basis of the control group.The hemodynamic parameters,excellent rate of anesthesia block,pain disappearance time,postoperative visual analogue scale(VAS)score and incidence of risk events were compared between the two groups.ResultsThe systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the ultrasound guidance group were lower than those in the control group at the time of incision(T_(1)),reduction of fracture(T_(2))and end of surgery(T_(3)),there were statistical differences(P<0.05).The excellent rate of anesthesia block in the ultrasound guidance group was higher than that in control group:98.57%(69/70)vs.85.71%(60/70),there was statistical difference(χ^(2)=6.31,P<0.05).The time of pain disappearance in the ultrasound guidance group was shorter than that in the control group:(6.18±1.52)min vs.(8.95±2.47)min,there was statistical difference(t=7.99,P<0.05).The visual analogue scale(VAS)scores at 3,6,12 and 24 h after operation in the ultrasound guided group were lower than those in the control group,there were statistical differences(P<0.05).There was no statistical difference in the incidence of risk events between the two groups(P>0.05).ConclusionsThe application of ultrasound guided block of brachial plexus nerve and cervical nerve in the treatment of clavicle fracture can stabilize hemodynamic parameters such as blood pressure of patients during operation,improve the excellent rate of anesth

关 键 词：超声检查 颈丛阻滞 臂丛神经阻滞 锁骨骨折 疼痛 手术后 血流动力学 

分 类 号：R614[医药卫生—麻醉学]