肩关节周围炎手法松解麻醉方式选择的临床研究

目的：探讨手法松解肩关节周围炎几种常用麻醉方式的安全性及可行性。方法：261例肩关节周围炎患者随机分为3组，Ⅰ组118例，采用臂丛神经阻滞麻醉。Ⅱ组116例，应用静脉麻醉。Ⅲ组为自愿局部麻醉者31例，给予局部麻醉。记录各组心率（HR）、无创平均动脉血压（MAP）、脉搏氧饱和度（SPO：）进行术前与术中对比；记录心电图（ECG）异常例数，进行组间对比。结果：Ⅲ组疼痛率高，松解到位率低，MAP增高，HR增快，ECG异常率高于Ⅰ组及Ⅱ组（P〈0．01）。Ⅰ组MAP增高，HR增快高于Ⅱ组（P〈0．05）。结论：芬太尼联合丙泊酚全麻在肩关节周围炎手法松解中是一种安全、无痛、镇静的麻醉方法。

Clinical Research on the Mode Selection of Anesthesia Methods of Manipulation Release for Periarthritis of Shoulder

Objective：To discuss the security and feasibility of several common anesthesia methods for manipulation release of periarthritis of shoulder. Methods ：261 cases of patients with periarthritis of shoulder were randomly divided to three groups. The group Ⅰ （ 118 cases ） were given brachial plexus nerve block anesthesia methods. The group Ⅱ （ 116 cases） were given intravenous anesthesia. The group Ⅲ （31 cases of voluntary localized anesthesia patients） were given localized anesthesia. Heart rate （ HR）, non-invasive mean arterial pressure （MAP） and SPO2 were noted before the treatment and in the operation so as to make contrast analysis;Abnormal Electrocrdiograph （ECG） cases were noted so as to make comparison among groups. Results：Pain rate in the group Ⅲ was high;releasing rate in the right place was low;Map increased;HR became fast ;abnormality rate of ECG would be higher than the group I and the group Ⅱ （P 〈 0. 01 ）. In the groupⅠ, MAP increased; the increase of HR was higher than group Ⅱ（P 〈 0.05）. Conclusion ： General anesthesia by Fentanyl combined with propofl is a kind of secure, analgesia and tranquilized method in manipulation release for periarthritis of shoulder.