Anesthetic effect of ultrasound-guided nerve block for internal fixation of clavicle fractures
10.3760/cma.j.cn341190-20230112-00028
- VernacularTitle:超声引导下神经阻滞用于锁骨骨折内固定术的效果观察
- Author:
Yan WEI
1
;
Qunbing LOU
Author Information
1. 义乌市中心医院麻醉科，义乌 322000
- Keywords:
Anesthesia;
Ultrasonography, interventional;
Brachial plexus block;
Cervical plexus block;
Fracture fixation;
Clavicle;
Heart rate;
Blood pressure
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(5):652-656
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the clinical efficacy and safety of ultrasound-guided brachial plexus block combined with superficial cervical plexus block during the internal fixation of clavicle fractures.Methods:A prospective randomized controlled study was conducted on 100 patients suffering from clavicular fractures who underwent open reduction and internal fixation at Yiwu Central Hospital between June 2019 and March 2022. Using a random number table method, the patients were divided into two groups: a conventional group ( n = 50) and an ultrasound-guided group ( n = 50). The conventional group received blind brachial plexus block combined with superficial cervical plexus block, while the ultrasound-guided group received brachial plexus block combined with superficial cervical plexus block under ultrasound guidance. The anesthesia indices of the patients were recorded, intraoperative vital signs were monitored, the anesthesia effect was evaluated, and adverse reactions to anesthesia were observed. Results:There were no significant differences in general data between the two groups, including age, sex, and ASA grading ( P > 0.05). The duration of anesthesia operation and the onset time of nerve block in the ultrasound-guided group [(5.70 ± 0.79) minutes and (7.28 ± 0.90) minutes] were significantly shorter compared with the conventional group [(12.18 ± 1.03) minutes and (14.55 ± 1.17) minutes, t = 18.92, 21.63, both P < 0.001]. However, the duration of nerve block in the ultrasound-guided group was (417.84 ± 13.88) minutes, which was significantly longer than that in the conventional group [(361.47 ± 12.19) minutes, t = 16.37, P < 0.001]. Additionally, the mean arterial pressure and heart rate in the ultrasound-guided group [(103.36 ± 2.22) mmHg (1 mmHg = 0.133 kPa), (103.02 ± 2.26) mmHg, (76.66 ± 4.51) beats/minute and (75.94 ± 4.34) beats/minute] were significantly lower compared with the conventional group [(103.36 ± 2.22) mmHg, (103.02 ± 2.26) mmHg, (76.66 ± 4.51) beats/minute, and (75.94 ± 4.34) beats/minute, t = 6.83, 5.52, 6.27, 4.96, all P < 0.001]. Furthermore, the effective rate of anesthesia in the ultrasound-guided group was 94.00% (47/50), which was significantly higher than that in the conventional group [76.00% (38/50), χ2 = 6.35, P < 0.05]. The overall incidence of adverse reactions to anesthesia in the ultrasound-guided group was 4.00% (2/50), which was significantly lower than that in the conventional group [20.00% (10/50), χ2 = 6.06, P < 0.05]. Conclusion:Ultrasound-guided brachial plexus block combined with superficial cervical plexus block for internal fixation of clavicular fractures can effectively shorten the onset time of anesthesia, minimize fluctuations in patients' intraoperative vital signs, improve the efficiency of anesthesia, and reduce the risk of adverse reactions.
