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比较颈浅丛和颈中丛阻滞用于中心静脉置管。

Comparison of Intermediate and Superficial Cervical Plexus Blocks for Central Venous Catheterisation.

机构信息

Department of Anaesthesiology and Reanimation, Konya Beyhekim Training and Research Hospital, Konya, Turkiye.

Department of Anaesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkiye.

出版信息

J Coll Physicians Surg Pak. 2024 Aug;34(8):869-873. doi: 10.29271/jcpsp.2024.08.869.

Abstract

OBJECTIVE

To compare the effectiveness of the superficial cervical plexus (SCP) and ultrasonography (USG)-guided intermediate cervical plexus (ICP) blocks for patient and operator satisfaction during central venous catheterisation (CVC).

STUDY DESIGN

Experimental study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, between May and July 2022.

METHODOLOGY

Eighty patients were randomly assigned to the ICP and SCP block groups before CVC. Patients received 10ml of a local anaesthesia. Pain levels were assessed during needle insertion, dilation, catheter insertion, and suturing, and 5 minutes after the procedure using a 10-point numeric rating scale (NRS). Thirty minutes post-procedure, patient and operator satisfaction were evaluated using a 5-point Likert-type scale.

RESULTS

The ICP block group had lower mean pain scores than the SCP block group during needle entry, dilation, and 5 minutes after CVC (p = 0.022, p <0.001, and p = 0.005, respectively). However, no significant differences were found in pain scores after the block application, during catheter insertion, and suturing (p = 0.279, p = 0.052, and p = 0.072, respectively). Patient and operator satisfaction scores did not significantly differ between the two groups (p = 0.189 and p = 0.329, respectively).

CONCLUSION

The study demonstrated that the ICP and SCP blocks resulted in comparable patient and operator satisfaction levels during CVC. Given that the ICP block resulted in lower pain scores at various stages of the procedure, it is a recommended method to enhance overall patient comfort and minimise the pain during CVC.

KEY WORDS

Central venous catheterisation, Intermediate cervical plexus block, Superficial cervical plexus block, Patient satisfaction.

摘要

目的

比较浅表颈丛(SCP)和超声(USG)引导的颈丛中部(ICP)阻滞在中心静脉置管(CVC)期间对患者和操作者满意度的效果。

研究设计

实验研究。研究地点和时间:土耳其科尼亚市医院麻醉科和复苏科,2022 年 5 月至 7 月。

方法

80 例患者在 CVC 前随机分为 ICP 和 SCP 阻滞组。患者接受 10ml 局部麻醉。在进针、扩张、导管插入和缝合过程中以及操作后 5 分钟使用 10 分制数字评分量表(NRS)评估疼痛程度。术后 30 分钟,使用 5 分 Likert 量表评估患者和操作者的满意度。

结果

ICP 阻滞组在进针、扩张和 CVC 后 5 分钟时的平均疼痛评分均低于 SCP 阻滞组(p = 0.022、p <0.001 和 p = 0.005)。然而,在阻滞后、导管插入和缝合过程中,疼痛评分无显著差异(p = 0.279、p = 0.052 和 p = 0.072)。两组患者和操作者的满意度评分无显著差异(p = 0.189 和 p = 0.329)。

结论

本研究表明,在 CVC 期间,ICP 和 SCP 阻滞均能获得相当的患者和操作者满意度。鉴于 ICP 阻滞在操作的各个阶段都能产生较低的疼痛评分,因此它是一种推荐的方法,可以提高患者的整体舒适度并减轻 CVC 期间的疼痛。

关键词

中心静脉置管、颈丛中部阻滞、浅表颈丛阻滞、患者满意度。

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