【原】【罌粟摘要】鎖骨骨折手術中單獨應用頸淺叢神經阻滯或聯合肌間溝臂叢神經阻滯：一項隨機臨床試驗

罌粟花anesthGH 2021-11-16

展開全文

鎖骨骨折手術中單獨應用頸淺叢神經阻滯或聯合肌間溝臂叢神經阻滯：一項隨機臨床試驗

貴州醫科大學麻醉與心臟電生理課題組

翻譯：陳銳編輯：陳銳審校：曹瑩

背景

適用于鎖骨骨折的區域麻醉技術一直存在爭議。本研究旨在比較頸淺神經叢單獨或聯合間肌間溝臂叢神經阻滯在鎖骨骨折內固定手術中的應用。

方法

將70例鎖骨骨折內固定術患者納入本臨床試驗，隨機分為兩組；頸淺叢神經阻滯（CPB）組和頸淺叢神經阻滯聯合肌間溝阻滯（ISB）組。在誘導全身麻醉之前進行區域麻醉。記錄術中芬太尼、異氟醚用量、術后嗎啡用量、術后疼痛評分、術后鎮痛持續時間、圍手術期并發癥發生率及患者滿意度。

結果

與聯合使用CPB和ISB相比，單獨使用CPB沒有顯著改變術后嗎啡消耗量（8.4±3.3 mg vs 7.3±3.2 mg [P=0.2]）術后首次鎮痛時間（396.7±193.4 min vs 407.7±150.0 min [P=0.8]），或術后疼痛評分（P?0.05）。術中芬太尼用量（P=0.3）、術中異氟醚用量（P=0.7）、圍手術期并發癥發生率、患者滿意度（P?0.05）均無變化。單獨使用CPB顯著降低膈神經麻痹的發生率（P=0.03）。

結論

在全身麻醉下的鎖骨骨折內固定術患者中，單獨使用SCP的圍手術期鎮痛效果與其聯合ISB效果相同。

原始文獻來源

Abdelghany MS, Ahmed SA, Afandy ME. Superficial cervical plexus block alone or combined with in-terscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial. Minerva Anestesiol 2021;87:523-32. DOI: 10.23736/S0375-9393.21.14865-5).

Superficial cervical plexus block alone or combined with interscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial

原

文

ABSTRACT

BACKGROUND: The regional anesthesia technique which is suitable for fracture clavicle is a matter of debate. This study aimed to compare the use of superficial cervical plexus alone or in combination with interscalene block in patients undergoing internal fixation of fractured clavicle.

METHODS: Seventy patients undergoing internal fixation of fractured clavicle were enrolled in this clinical trial and randomly distributed into two groups; superficial cervical plexus block (CPB) group and combined superficial cervical plexus block and interscalene block (ISB) group. The regional anesthesia techniques were performed before induction of general anesthesia. The intraoperative fentanyl and isoflurane consumption, the postoperative morphine consumption, the postoperative pain score, the duration of postoperative analgesia, the incidence of perioperative complications, and the patient’s satisfaction were recorded.

RESULTS: In comparison to the use of combined CPB and ISB, the use of CPB alone did not significantly change the postoperative morphine consumption (8.4±3.3 mg versus 7.3±3.2 mg [P=0.2]), the time to the first request of postoperative analgesia (396.7 193.4 min versus 407.7±150.0 min [P=0.8]), or the postoperative pain score (P>0.05). Also, it did not change the intraoperative fentanyl consumption (P=0.3), the intraoperative isoflurane consumption (P=0.7), the incidence of perioperative complication, or the degree of patient’s satisfaction (P>0.05). It significantly decreased the incidence of phrenic nerve palsy (P=0.03).

CONCLUSIONS: In patients undergoing internal fixation of clavicular fracture, the perioperative analgesic effect of SCP alone is equally effective to its use in combination with ISB.

(Cite this article as: Abdelghany MS, Ahmed SA, Afandy ME. Superficial cervical plexus block alone or combined with interscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial. Minerva Anestesiol 2021;87:523-32. DOI: 10.23736/S0375-9393.21.14865-5)

KEY WORDS: Cervical plexus; Analgesia; Clavicle