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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.

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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