超声引导下前路肩胛上神经阻滞对肩关节镜手术患者术后恢复质量的影响

目的 评估超声引导下前路肩胛上神经阻滞(SSNB)对肩关节镜手术患者术后恢复质量的影响.方法 选择择期行单侧肩关节镜肩袖修补术患者60例,男25例,女35例,年龄18～64岁,BMI 18～25 kg/m2,ASAⅠ或Ⅱ级.采用随机数字法将患者随机分为两组:前路SSNB组(S组)和肌间沟臂丛神经阻滞(ISBPB)组(I...

Effect of ultrasound-guided anterior suprascapular nerve block on postoperative recovery quality in patients undergoing shoulder arthroscopic surgery

Objective To evaluate the effect of ultrasound-guided anterior suprascapular nerve block(SSNB)on postoperative recovery quality in patients undergoing shoulder arthroscopic surgery.Methods Sixty patients who received unilateral arthroscopic repair of rotator cuff,25 males and 35 females,aged 18-64 years,BMI 18-25 kg/m²,ASA physical statusⅠorⅡ,were involved in the study.All the patients were randomized into two groups:SSNB group(group S)and interscalene brachial plexus block(ISBPB)group(group I),30 patients in each group.Before the induction of general anesthesia,the patients in group S were performed ultrasound-guided anterior SSNB,and the patients in group I were treated with ultrasound-guided ISBPB,all administrated with 0.375%ropivacaine 15 ml.All the patients underwent patient-controlled intravenous analgesia(PCIA)after surgery.Visual analog scale(VAS)at rest were examined 30 minutes after extubation,3,6,12,24 hours postoperatively,and VAS on upper-limb movement were examined at 12 and 24 hours postoperatively.The diaphragmatic paralysis was evaluated before the block,30 minutes after the block,and 3 hours after extubation,and forced expiratory volume in one second(FEV₁)and forced vital capacity(FVC)were recorded at corresponding time points.The number of effective pressing times of PCIA pump and the number of patients who received remedial analgesia within 24 hours after operation were recorded.The incidence of chronic pain was calculated 3 months after operation.Anxiety/depression were measured at 3 months postoperatively.Results Compared with group I,VAS score at rest 30 minutes after extubation was higher in group S(P<0.05).Compared with group I,the diaphragmatic paralysis rate in group S was lower 30 minutes after block(P<0.05).Compared with 30 minutes after block,the diaphragmatic paralysis rate was lower 3 hours after extubation in group I(P<0.05).Compared with before block,FEV₁ and FVC in group I were significantly decreased 30 minutes after block(P<0.05).FEV₁ and FVC in group S were significantly increased 30 minutes after block than those in group I(P<0.05).There was no significant difference in the effective pressing times and remedial analgesia rate between the two groups within 24 hours postoperatively.There was no significant difference in the incidence of chronic pain and anxiety/depression 3 months after operation.Conclusion Compared with ISBPB,ultrasound-guided anterior SSNB provides analgesia with less impact on postoperative lung function and dose not increase the incidence of chronic pain or anxiety/depression 3 months after surgery.