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肩关节镜术前肩前囊阻滞与肌间沟臂丛阻滞的比较:初步分析。

Comparison of shoulder anterior capsular block and interscalene brachial plexus block for shoulder arthroscopy: a preliminary analysis.

机构信息

Department of Anesthesiology and Reanimation, Haseki Training and Research Hospital, Istanbul, Türkiye -

Department of Orthopedic and Traumatology, Haseki Training and Research Hospital, Istanbul, Türkiye.

出版信息

Minerva Anestesiol. 2024 Jan-Feb;90(1-2):22-30. doi: 10.23736/S0375-9393.23.17536-5. Epub 2023 Nov 23.

Abstract

BACKGROUND

This study aims to reveal the perioperative analgesic efficacy of a new technique, anterior capsular shoulder block, in treating pain after shoulder arthroscopy compared to the interscalene brachial plexus block.

METHODS

The study design is randomized, prospective, interventional, standardized and double-blind in the setting of orthopedic operating room and orthopedic postoperative ward. Forty patients between 18-90 years of age and with American Society of Anesthesiologists Physical Status classification I to III who received arthroscopic cuff repair surgery were randomized into two (1:1 distribution; N.=20) groups. The interventions were interscalene brachial plexus block for Group A and shoulder anterior capsular block for Group B. Primary measurements were pain scores within 48 hours. Secondarily total analgesia requirement, intraoperative heart rate and blood pressure, arthroscopic image quality were evaluated.

RESULTS

Pain scores within postoperative 48 hours were similar between SHAC and ISB groups with no significant difference (P>0.05). Total analgesia requirement, intraoperative and postoperative rescue analgesia, was also similar with no significance (P>0.05).

CONCLUSIONS

This study demonstrated that the anterior capsular shoulder block is an effective alternative with similar results to the interscalene brachial plexus block for managing pain after shoulder arthroscopy.

摘要

背景

本研究旨在比较新的技术——前囊肩部阻滞与肌间沟臂丛阻滞在治疗肩关节镜术后疼痛方面的围手术期镇痛效果。

方法

该研究设计为在骨科手术室和骨科术后病房中进行的随机、前瞻性、干预性、标准化和双盲研究。选择年龄在 18-90 岁之间,美国麻醉医师协会身体状况分级 I 至 III 级,接受关节镜肩袖修复手术的 40 名患者,按 1:1 比例随机分为两组(N=20)。干预措施为 A 组行肌间沟臂丛阻滞,B 组行肩部前囊阻滞。主要测量指标为术后 48 小时内的疼痛评分。次要测量指标为总镇痛需求、术中心率和血压、关节镜图像质量。

结果

术后 48 小时内,SHAC 组和 ISB 组的疼痛评分相似,无显著差异(P>0.05)。总镇痛需求、术中及术后解救性镇痛也相似,无显著差异(P>0.05)。

结论

本研究表明,前囊肩部阻滞是一种有效的替代方法,与肌间沟臂丛阻滞在治疗肩关节镜术后疼痛方面具有相似的效果。

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