摘要
目的本文深入分析超声引导下星状神经节阻滞对肩关节镜手术患者术后急性疼痛的影响。方法在2020年11月-2021年11月入院实施肩关节镜手术治疗的患者中任意择取58例纳入研究,通过计算机系统予以分组,对照组自动纳入29例选用全身麻醉,观察组中纳入另外29例,实施超声引导下星状神经节阻滞术。通过下列指标进行分析:①手术指标;②MAP、HR不同时间点变化;③氧化应激指标及免疫指标;④不同时间点膈肌麻痹情况;⑤术后不良反应情况;⑥术后镇痛泵补救情况。结果①观察组手术时间与麻醉时间相较于对照组而言明显更短,两组所用时间比较有统计学意义(P<0.05);②在不同时间点,观察组MAP指标和HR指标稳定性均优于对照组,组间结果比较有统计学意义(P<0.05);③观察组SOD、MDA、IgA以及IgG指标相较于对照组相同指标而言改善效果明显更好,两组氧化应激指标与免疫指标对比差异明显(P<0.05);④观察组神经阻滞后30min和1h、2h、3h膈肌麻痹发生率均低于对照组,二者对比有统计学意义(P<0.05);⑤观察组术后不良反应发生率为6.9%,低于对照组术后不良反应发生率(27.6%),组间结果对比有统计学意义(P<0.05);⑥观察组术后镇痛泵补救镇痛例数明显少于对照组,且有效按压次数低于对照组,两组间结果对比差异显著(P<0.05)。结论在肩关节镜手术患者中展开超声引导下星状神经节阻滞麻醉的镇痛效果更加理想,可在很大程度上减少术后镇痛泵的使用,对生命体征影响较少的同时,膈肌麻痹效果更好,手术安全性更高,值得推广应用。
Objective The paper deeply analyzed effect of ultrasound-guided stellate ganglion block for postoperative acute pain of patietns with shoulder arthroscopic surgery.Methods The paper chose 58 patients with shoulder arthroscopic surgery from November 2020 to November 2021 for study,and divided them into groups and randomly with computer system.Control group automatically included 29 cases under general anesthesia,while observation group included another 29 cases with ultrasound guided stellate ganglion block.The following indicators were analyzed:①surgical indicators;②MAP and HR changes at different time points;③oxidative stress indicators and immune indicators;④phragmatic paralysis at different time points;⑤postoperative adverse reactions;⑥postoperative analgesia pump rescue situation.Results①Observation group had significantly shorter surgical and anesthesia times than control group,time used in two groups was statistically significant(P<0.05).②At different time points,stability of MAP and HR indicators in observation group was better than control group,results between groups were statistically significant(P<0.05).Improvement effect of SOD,MDA,IgA,and IgG indicators in observation group was significantly better than control group,there was significant difference in oxidative stress indicators and immune indicators between two groups(P<0.05).Incidence of diaphragmatic paralysis in observation group was lower than control group at 30 minutes and 1,2,and 3 hours after nerve block,with statistical significance(P<0.05).Incidence of postoperative adverse reactions in observation group was 6.9%,which was lower than 27.6%of control group,comparison results between groups was statistically significant(P<0.05).⑥Observation group had significantly fewer cases of postoperative analgesic pump rescue analgesia than control group,number of effective compressions was lower than control group,results difference between two groups was significant(P<0.05).Conclusion Ultrasoundguided stellate ganglion block anesthesia can achieve ideal analgesic effect for patients with shoulder arthroscopic surgery,can reduce postoperative analgesic pumps greatly and have less effect on vital signs.At the same time,it has better effect of diaphragm paralysis,with higher surgical safety,which is worthy of promotion and application.
作者
姜福玉
JIANG Fuyu(Wuxi City Xinwu District Traditional Chinese Medicine Hospital,Wuxi,Jiangsu 214000)
出处
《智慧健康》
2023年第6期139-143,共5页
Smart Healthcare
关键词
肩关节镜手术
超声引导下星状神经节阻滞
镇痛效果
体征变化
安全性
Shoulder arthroscopic surgery
Ultrasound guided stellate gangl ion block
Analgesic effect
Physical signs changes
Safety
