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自卷曲导管用于关节镜下肩袖修补手术患者连续肌间沟臂丛神经阻滞时的孔位置对术后疼痛的影响:一项前瞻性观察研究。

The impact of the pore position of a self-coiling catheter for continuous interscalene brachial plexus block on postoperative pain in patients undergoing arthroscopic rotator cuff repair surgery: a prospective observational study.

作者信息

Hara Marie, Ikuta Yoshihiro, Hirata Naoyuki

机构信息

Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University Hospital, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto City, 860-8556, Japan.

Surgical Center, Kumamoto University Hospital, 1-1-1 Honjo, , Kumamoto City, 860-8556, Japan.

出版信息

J Anesth. 2025 Feb 22. doi: 10.1007/s00540-025-03465-2.

DOI:10.1007/s00540-025-03465-2
PMID:39985569
Abstract

This prospective observational study aimed to investigate the usefulness of the self-coiling catheter for continuous interscalene brachial plexus block (CISB) in patients undergoing arthroscopic rotator cuff repair (ARCR). In 22 patients, the self-coiling tip of catheter was placed anterior to the C5 and C6 roots under ultrasound guidance. The primary outcome is the relationship between the distance from the distal side pore of the catheter to the C5/C6 nerve roots and the visual analogue scale (VAS) of postoperative pain. The distance was recorded as a positive value when the distal pore was anterior to the C5/C6 nerve roots, and as a negative value when it was posterior to the roots. The median distance from the distal pore to C5/C6 nerve roots was 5.0 [4.1, 6.5] mm at catheter placement before surgery and 0.0 [- 4.3, 2.2] mm at catheter removal the day after surgery. The distance between the distal pore and the cervical nerve roots was associated with the VAS score at catheter removal (r =- 0.455, P = 0.033). These findings suggest that the distance between the distal pore of the self-coiling catheter and the C5/C6 nerve roots may affect the analgesic effect of CISB after ARCR.

摘要

这项前瞻性观察性研究旨在调查自卷曲导管在接受关节镜下肩袖修复术(ARCR)的患者连续肌间沟臂丛神经阻滞(CISB)中的应用价值。在22例患者中,在超声引导下将导管的自卷曲尖端置于C5和C6神经根前方。主要结局是导管远端孔到C5/C6神经根的距离与术后疼痛视觉模拟量表(VAS)之间的关系。当远端孔位于C5/C6神经根前方时,该距离记录为正值;当位于神经根后方时,记录为负值。术前放置导管时,远端孔到C5/C6神经根的中位距离为5.0[4.1,6.5]mm,术后第一天拔除导管时为0.0[-4.3,2.2]mm。拔除导管时,远端孔与颈神经根之间的距离与VAS评分相关(r = -0.455,P = 0.033)。这些发现表明,自卷曲导管远端孔与C5/C6神经根之间的距离可能会影响ARCR术后CISB的镇痛效果。

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本文引用的文献

1
Self-coiling catheter for continuous interscalene block.用于连续肌间沟阻滞的自卷曲导管
J Anesth. 2021 Dec;35(6):939-940. doi: 10.1007/s00540-021-02999-5. Epub 2021 Sep 15.
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Distance of catheter tip dislocation in continuous interscalene brachial plexus block.连续肌间沟臂丛神经阻滞中导管尖端移位的距离
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Incidence and effects of postoperative migration of interscalene catheter tips placed using ultrasound-guided anterior and posterior approaches.
超声引导前入路和后入路置管术后肌间沟导管尖端迁移的发生率和影响。
J Anesth. 2021 Apr;35(2):175-183. doi: 10.1007/s00540-020-02888-3. Epub 2021 Jan 8.
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The Effect of Fixation Technique on Continuous Interscalene Nerve Block Catheter Success: A Randomized, Double-Blind Trial.固定技术对连续肌间沟神经阻滞导管成功率的影响:一项随机、双盲试验。
Anesth Analg. 2017 Mar;124(3):959-965. doi: 10.1213/ANE.0000000000001811.
5
Even a "pigtail" distal end catheter can enter the epidural space after continuous paravertebral block.即使是“猪尾”状远端导管在连续椎旁阻滞术后也可进入硬膜外间隙。
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6
An analysis of 1505 consecutive patients receiving continuous interscalene analgesia at home: a multicentre prospective safety study.1505 例连续在家中接受连续肌间沟镇痛的患者分析:一项多中心前瞻性安全性研究。
Anaesthesia. 2016 Apr;71(4):373-9. doi: 10.1111/anae.13385. Epub 2016 Feb 5.
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Continuous interscalene block in patients having outpatient rotator cuff repair surgery: a prospective randomized trial.连续肌间沟阻滞在门诊肩袖修补手术患者中的应用:一项前瞻性随机试验。
Anesth Analg. 2013 Dec;117(6):1485-92. doi: 10.1213/01.ane.0000436607.40643.0a.
8
Dislocation rates of perineural catheters: a volunteer study.神经周围导管的脱位率:一项志愿者研究。
Br J Anaesth. 2013 Nov;111(5):800-6. doi: 10.1093/bja/aet198. Epub 2013 Jun 7.
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Investigation of the freely available easy-to-use software 'EZR' for medical statistics.医学统计学中免费易用软件 EZR 的调查研究。
Bone Marrow Transplant. 2013 Mar;48(3):452-8. doi: 10.1038/bmt.2012.244. Epub 2012 Dec 3.
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Placement of coiled catheters into the paravertebral space.将盘管导管置于椎旁间隙中。
Anaesthesia. 2012 Mar;67(3):250-5. doi: 10.1111/j.1365-2044.2011.06988.x.