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肩胛上神经阻滞治疗偏瘫肩痛的有效性:一项系统评价和Meta分析

Effectiveness of Suprascapular Nerve Block in the Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis.

作者信息

Hou Yajing, Wang Yong, Sun Xiaojing, Lou Yake, Yu Ying, Zhang Tong

机构信息

School of Rehabilitation Medicine, Capital Medical University, Department of Neurological Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Lab of Brain Injury Repair and Rehabilitation, China Rehabilitation Science Institute, Beijing, China.

Rehabilitation Medicine Center, Fuxing Hospital, Capital Medical University, Beijing, China.

出版信息

Front Neurol. 2021 Oct 5;12:723664. doi: 10.3389/fneur.2021.723664. eCollection 2021.

Abstract

We aimed to investigate the effectiveness of suprascapular nerve block (SSNB) in patients with hemiplegic shoulder pain (HSP). SSNB is widely used in various shoulder pains, but whether it is effective in HSP remains unknown. PubMed, Cochrane Library, and Embase databases were searched to identify potential citations. Randomized controlled trials meeting the eligible criteria were included in our analysis. The primary endpoint was Visual Analog Scale (VAS) with a maximum value of 100 and a minimum value of 0. Secondary endpoints were passive range of motion (PROM) that pain starts, and the PROM mainly included abduction, flexion, and external rotation. In addition, the upper extremity Fugl-Meyer assessment (FMA) was also included in our secondary endpoints. Eight studies with 281 patients were included in our analysis. For VAS, there was no obvious difference between SSNB group and control group regardless of the follow-up period (<4 weeks or ≥4 weeks), which were -6.62 (-15.76, 2.53; = 0.16) and 1.78 (-16.18, 19.74; = 0.85). For shoulder function, the PROM of abduction, flexion, and external rotation was similar between groups. However, motor function indicator FMA is lower in SSNB control than that in control group, with a mean difference (and 95% CI) of -2.59 (-4.52, -0.66; = 0.008). SSNB is an effective way for HSP patients. Registration ID: CRD42021252429.

摘要

我们旨在研究肩胛上神经阻滞(SSNB)对偏瘫肩痛(HSP)患者的有效性。SSNB广泛应用于各种肩部疼痛,但它对HSP是否有效仍不清楚。我们检索了PubMed、Cochrane图书馆和Embase数据库以识别潜在的文献引用。符合入选标准的随机对照试验纳入我们的分析。主要终点是视觉模拟量表(VAS),最大值为100,最小值为0。次要终点是疼痛开始时的被动活动范围(PROM),PROM主要包括外展、屈曲和外旋。此外,上肢Fugl-Meyer评估(FMA)也纳入我们的次要终点。我们的分析纳入了8项研究共281例患者。对于VAS,无论随访期(<4周或≥4周),SSNB组和对照组之间均无明显差异,分别为-6.62(-15.76,2.53;P = 0.16)和1.78(-16.18,19.74;P = 0.85)。对于肩部功能,各组之间外展、屈曲和外旋的PROM相似。然而,SSNB组的运动功能指标FMA低于对照组,平均差异(及95%CI)为-2.59(-4.52,-0.66;P = 0.008)。SSNB是HSP患者的一种有效治疗方法。注册号:CRD42021252429。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98a8/8523895/302586d18cb5/fneur-12-723664-g0001.jpg

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