微创医学2025，Vol.20Issue(4)：413-421,9.DOI:10.11864/j.issn.1673.2025.04.07
超声引导下肩关节囊周围神经阻滞联合颈浅丛神经阻滞在肩关节镜手术中的应用效果
Application effect of ultrasound-guided peripheral nerve block around the shoulder joint capsule combined with superficial cervical plexus block in arthroscopic shoulder surgery
摘要
Abstract
Objective To investigate the application effect of ultrasound-guided peripheral nerve block around the shoulder joint capsule combined with superficial cervical plexus block(SCPB)in perioperative analgesia of arthroscopic shoulder surgery.Methods Sixty patients undergoing arthroscopic shoulder surgery under general anesthesia combined with peripheral nerve block were selected as the research subjects,and they were randomly divided into an observation group and a control group,with 30 cases in each group.The observation group was administered peripheral nerve block around the shoulder joint capsule combined with SCPB,while the control group was administered inter-scalene brachial plexus block(ISB)combined with SCPB.The mean arterial pressure,heart rate and pulse oxygen saturation of patients in both groups were recorded at the following time points:on admission to the operating room(T0),after anesthesia induction(T1),beginning of surgery(T2),15 minutes after the start of surgery(T3),at the end of surgery(T4),6 hours after surgery(T5),9 hours after surgery(T6),12 hours after surgery(T7),24 hours after surgery(T8).The surgery-related indicators of the two groups,including intraoperative blood loss,surgical duration,extubation time,and total dosage of propofol and remifentanil,were statistically analyzed;meanwhile,diaphragmatic function,postoperative analgesic effect,time to first request for postoperative analgesia,frequency of rescue analgesia,and occurrence of postoperative adverse reactions were evaluated.Results There was no statistically significant difference in perioperative mean arterial pressure,heart rate and pulse oxygen saturation between the two groups at all time points(P>0.05);only at T6,the pulse oxygen saturation in the observation group was higher than that in the control group(P<0.05);when comparing intraoperative blood loss,surgical duration,extubation time,total dosage of propofol and remifentanil between the two groups,no statistically significant difference was found(P>0.05).In terms of diaphragmatic function,there was no statistically significant difference between the two groups in pre-and post-block diaphragmatic excursion,changes in diaphragmatic excursion,and pre-and post-block diaphragmatic thickness;however,the incidence of diaphragmatic paralysis in the observation group was slightly lower than that in the control group(P>0.05).Regarding postoperative analgesic effect,no statistically significant differences were observed between the two groups in postoperative resting pain score and proportion of postoperative rescue analgesia(P>0.05).Conclusion In arthroscopic shoulder surgery,adopting peripheral nerve block around the shoulder joint capsule combined with SCPB can achieve a comparable analgesic effect to that of ISB combined with SCPB,while reducing the incidence of diaphragmatic paralysis.关键词
肩关节囊周围神经阻滞/臂丛神经阻滞/颈丛阻滞/膈肌麻痹/肩关节镜手术/术后镇痛Key words
Peripheral nerve group block around the shoulder joint capsule/Brachial plexus block/Cervical plexus block/Diaphragmatic paralysis/Arthroscopic shoulder surgery/Postoperative analgesic引用本文复制引用
黄奕,何玉花,何丽婷,冯丝丝,柏宏哲,林成新,舒礼佩..超声引导下肩关节囊周围神经阻滞联合颈浅丛神经阻滞在肩关节镜手术中的应用效果[J].微创医学,2025,20(4):413-421,9.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-A20240447) （编号:Z-A20240447）
广西医疗卫生适宜技术开发与推广应用项目(编号:S2021109) （编号:S2021109）
