University Hospital of North Norway and UiT-The Arctic University of Norway, Tromsø, Norway.
Anaesthesia. 2016 Aug;71(8):938-47. doi: 10.1111/anae.13504.
Some surgeons believe that infraclavicular brachial plexus blocks tends to result in supination of the hand/forearm, which may make surgical access to the dorsum of the hand more difficult. We hypothesised that this supination may be reduced by the addition of a suprascapular nerve block. In a double-blind, randomised, placebo-controlled study, our primary outcome measure was the amount of supination (as assessed by wrist angulation) 30 min after infraclavicular brachial plexus block, with (suprascapular group) or without (control group) a supplementary suprascapular block. All blocks were ultrasound-guided. The secondary outcome measure was an assessment by the surgeon of the intra-operative position of the hand. Considering only patients with successful nerve blocks, mean (SD) wrist angulation was lower (33 (27) vs. 61 (44) degrees; p = 0.018) and assessment of the hand position was better (11/11 vs. 6/11 rated as 'good'; p = 0.04) in the suprascapular group. The addition of a suprascapular nerve block to an infraclavicular brachial plexus block can provide a better hand/forearm position for dorsal hand surgery.
一些外科医生认为，锁骨下臂丛神经阻滞往往会导致手/前臂旋后，这可能使手部背侧的手术入路更加困难。我们假设通过附加肩胛上神经阻滞可以减少这种旋后。在一项双盲、随机、安慰剂对照研究中，我们的主要结局测量指标是锁骨下臂丛神经阻滞后 30 分钟时的旋后程度（通过腕关节角度评估），分为附加肩胛上神经阻滞（肩胛上组）和不附加（对照组）。所有阻滞均为超声引导。次要结局测量指标是外科医生对手部术中位置的评估。仅考虑到神经阻滞成功的患者，平均（标准差）腕关节角度较低（33 （27）度 vs. 61 （44）度；p=0.018），并且肩胛上组的手部位置评估更好（11/11 比 6/11 评为“良好”；p=0.04）。在锁骨下臂丛神经阻滞中附加肩胛上神经阻滞可为手部背侧手术提供更好的手/前臂位置。
