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连续肌间沟阻滞与单纯全身麻醉对接受关节镜下肩袖修补术患者功能结局的比较。

A comparison of continuous interscalene block versus general anesthesia alone on the functional outcomes of the patients undergoing arthroscopic rotator cuff repair.

作者信息

Gurger Murat, Ozer Ayse Belin

机构信息

Department of Orthopedics and Traumatology, Faculty of Medicine, Firat University Hospital, 23190, Elazig, Turkey.

Department of Anesthesiology, Faculty of Medicine, Inonu University Hospital, 44280, Malatya, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2019 Dec;29(8):1659-1666. doi: 10.1007/s00590-019-02482-8. Epub 2019 Jun 26.

Abstract

PURPOSE

The aim of this prospective and randomized study was to compare the effects of general anesthesia to the combination of general anesthesia and continuous interscalene block on postoperative pain and functional outcomes in patients undergoing arthroscopic rotator cuff repair.

METHODS

This study included a total of 85 patients aged 45-74 years, who were scheduled for elective arthroscopic rotator cuff repair. One group consists of patients who underwent only general anesthesia (GA, N = 43), and the other group consists of patients who underwent a combination of continuous interscalene brachial plexus block and general anesthesia (CISB + GA, N = 42). Pain levels of the patients were evaluated postoperatively by a visual analog scale. Shoulder function was evaluated preoperatively and postoperatively using the Constant score.

RESULTS

Patients in the CISB + GA group had lower postoperative visual analog scores and less additional analgesic needs during the early postoperative period than those in the GA group. Constant scores of the patients in the CISB + GA group at postoperative week 6 were higher than those in the GA group. Evaluation of the functional outcomes at 6 months postoperatively showed that there were no significant differences between the two groups.

CONCLUSION

Although CISB significantly improved postoperative pain control and early (in the first 6 weeks) functional outcomes following arthroscopic rotator cuff repair, there was no significant difference between the CISB group and CISB + GA group at 6 months.

LEVEL OF EVIDENCE

Level II, Randomized Controlled Trial, Treatment Study.

摘要

目的

这项前瞻性随机研究的目的是比较全身麻醉与全身麻醉联合连续肌间沟阻滞对接受关节镜下肩袖修复术患者术后疼痛和功能结局的影响。

方法

本研究共纳入85例年龄在45至74岁之间、计划进行择期关节镜下肩袖修复术的患者。一组由仅接受全身麻醉的患者组成(全身麻醉组,N = 43),另一组由接受连续肌间沟臂丛神经阻滞联合全身麻醉的患者组成(连续肌间沟阻滞联合全身麻醉组,N = 42)。术后通过视觉模拟量表评估患者的疼痛程度。术前和术后使用Constant评分评估肩部功能。

结果

连续肌间沟阻滞联合全身麻醉组患者术后视觉模拟评分较低,术后早期额外镇痛需求少于全身麻醉组。连续肌间沟阻滞联合全身麻醉组患者术后第6周的Constant评分高于全身麻醉组。术后6个月的功能结局评估显示,两组之间无显著差异。

结论

尽管连续肌间沟阻滞显著改善了关节镜下肩袖修复术后的疼痛控制和早期(前6周)功能结局,但连续肌间沟阻滞组与连续肌间沟阻滞联合全身麻醉组在6个月时无显著差异。

证据水平

二级,随机对照试验,治疗研究。

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