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在肌间沟阻滞基础上加用锯肌平面阻滞能否提高肩关节镜手术的麻醉质量?一项前瞻性随机研究。

Does the Serratus Plane Block Added to the Interscalene Block Improve the Quality of Anesthesia in Arthroscopic Shoulder Surgery? A Prospective Randomized Study.

作者信息

Demir Ufuk, Yayik Ahmet Murat, Köse Mehmet, Aydin Muhammed E, Ates İrem, Ahiskalioglu Ali

机构信息

Anesthesiology and Reanimation, Kastamonu State Hospital, Kastamonu, TUR.

Anesthesiology and Reanimation, Ataturk University School of Medicine, Erzurum, TUR.

出版信息

Cureus. 2020 Apr 12;12(4):e7648. doi: 10.7759/cureus.7648.

Abstract

BACKGROUND

Interscalene brachial plexus block (ISBPB) is the gold standard method in shoulder surgery. Serratus plane block (SPB) provides anesthesia in hemithorax, axillary region, and posterior of the shoulder. This randomized controlled study evaluated the effect of SPB added to ISBPB on surgical anesthesia quality in arthroscopic shoulder surgery.

METHODS

Sixty patients undergoing arthroscopic shoulder surgery were randomly assigned to two groups. All surgeries were performed under regional anesthesia. The Group I (Group Interscalene) (n=30) received ultrasound-guided interscalene block. In the Group IS (Group Interscalene + Serratus) (n=30), ultrasound-guided interscalene block and SPB were performed. Intraoperative anesthetic agent consumption, postoperative opioid consumption, postoperative pain scores, patient satisfaction, and surgeon satisfaction were evaluated.

RESULTS

Intraoperative propofol (60.00 ± 45.49 vs. 24.00 ± 32.97, respectively) and fentanyl (33.33 ± 23.97 vs. 18.33 ± 24.51, respectively) consumption were significantly higher in Group I than in Group IS (p < 0.05). There was no statistically significant difference between the groups at any of the times the postoperative opioid consumption and pain scores were evaluated (p > 0.05).

CONCLUSIONS

SPB added to the ISBPB increases the quality of surgical anesthesia and reduces the need for intraoperative sedoanalgesia for arthroscopic shoulder surgery.

摘要

背景

肌间沟臂丛神经阻滞(ISBPB)是肩部手术的金标准方法。锯肌平面阻滞(SPB)可在半胸、腋窝区域和肩部后方提供麻醉。这项随机对照研究评估了在ISBPB基础上加用SPB对关节镜肩部手术麻醉质量的影响。

方法

60例行关节镜肩部手术的患者被随机分为两组。所有手术均在区域麻醉下进行。第一组(肌间沟组)(n = 30)接受超声引导下的肌间沟阻滞。在IS组(肌间沟 + 锯肌组)(n = 30)中,实施超声引导下的肌间沟阻滞和SPB。评估术中麻醉药物消耗量、术后阿片类药物消耗量、术后疼痛评分、患者满意度和外科医生满意度。

结果

第一组术中丙泊酚(分别为60.00 ± 45.49与24.00 ± 32.97)和芬太尼(分别为33.33 ± 23.97与18.33 ± 24.51)的消耗量显著高于IS组(p < 0.05)。在评估术后阿片类药物消耗量和疼痛评分的任何时间点,两组之间均无统计学显著差异(p > 0.05)。

结论

在ISBPB基础上加用SPB可提高关节镜肩部手术的麻醉质量,并减少术中镇静镇痛的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7b3/7153816/634e8e58db94/cureus-0012-00000007648-i01.jpg

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