Gohl M R, Moeller R K, Olson R L, Vacchiano C A
Naval Hospital, Camp Pendleton, Calif., USA.
AANA J. 2001 Apr;69(2):105-9.
Several studies have demonstrated that interscalene brachial plexus anesthesia alone decreases postoperative pain, nausea, vomiting, urinary retention, and unplanned hospital admissions compared with general anesthesia alone. Anecdotal evidence suggests that an interscalene block combined with general anesthesia decreases unwanted effects of general anesthesia following open shoulder surgery. We compared the effect of combined interscalene block and general anesthesia with general anesthesia alone on Aldrete scores, length of postanesthesia care unit (PACU) stay, verbal rating scale (VRS) pain scores, incidence of postoperative narcotic administration and nausea, and patient satisfaction in a convenience sample of 52 men and women, ASA physical status I, II, or III. Group 1 received standard general anesthesia alone. Group 2 received an interscalene block in combination with general anesthesia using a standard technique. Group 2 had significantly lower VRS scores than group 1 while in the PACU, on the day of surgery, and on postoperative days 1 and 2. Overall satisfaction with the anesthetic technique was higher in the group 2 than in group 1. Results suggest that adding an interscalene block to general anesthesia can be of value in today's outpatient-dominated surgery schedule.
多项研究表明，与单纯全身麻醉相比，单纯肌间沟臂丛神经阻滞可减轻术后疼痛、恶心、呕吐、尿潴留及意外住院情况。有轶事证据表明，肌间沟阻滞联合全身麻醉可减轻肩部开放手术后全身麻醉的不良影响。我们在52例ASA身体状况为I、II或III级的男性和女性便利样本中，比较了肌间沟阻滞联合全身麻醉与单纯全身麻醉对Aldrete评分、麻醉后监护病房（PACU）停留时间、视觉模拟评分法（VRS）疼痛评分、术后使用麻醉剂和恶心的发生率以及患者满意度的影响。第1组仅接受标准全身麻醉。第2组采用标准技术将肌间沟阻滞与全身麻醉联合使用。在PACU期间、手术当天以及术后第1天和第2天，第2组的VRS评分显著低于第1组。第2组对麻醉技术的总体满意度高于第1组。结果表明，在当今以门诊手术为主的手术安排中，在全身麻醉中加入肌间沟阻滞可能具有价值。
