Anesthetic effects of cervical plexus C4 transverse process block one-point method under ultrasound guidance in internal fixation of clavicle fracture
10.3969/j.issn.1009-0754.2023.12.011
- VernacularTitle:超声引导下颈丛C4横突阻滞一点法在锁骨骨折内固定术中的麻醉效果观察
- Author:
Lianjun ZHI
1
;
Huiru CAI
;
Shuang WANG
;
Xiaochang ZHU
Author Information
1. 223805 江苏 宿迁,宿迁市中医院麻醉科
- Keywords:
Clavicle fracture;
Internal fixation;
Ultrasound guidance;
Cervical plexus C4 transverse process block one-point method;
Anesthetic effect
- From:
Journal of Navy Medicine
2023;44(12):1264-1269
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the anesthetic effects of cervical plexus C4 transverse process block one-point method under ultrasound guidance in internal fixation of clavicle fracture.Methods Eighty patients with clavicle fracture admitted to Suqian Traditional Chinese Medicine Hospital from October 2019 to October 2021 were randomly assigned(1∶1)to control group,or experimental group according to radom number table.The control group was anesthetized by cervical plexus C4 transverse process block one-point method with blind exploration,while the experimental group was anesthetized by cervical plexus C4 transverse process block one-point method under ultrasound guidance.The completion time of nerve block and surgical time were compared between the 2 groups.The hemodynamics(heart rate[HR],mean artery pressure[MVP]),and analgesic effects(visual analogue scale[VAS])before anesthesia(T0),during surgical skin incision(T1),fracture reduction(T2),and during surgical skin suture(T3)were also compared between the 2 groups.The anesthetic efficacy and anesthesia-related adverse reactions were statistically analyzed.Results There were no significant differences in surgical time between the 2 groups(P>0.05).The completion time of nerve block in the experimental group was significantly shorter than that in the control group(P<0.05).There were significant differences in the levels of HR and MAP at different time points of the 2 groups,when comparisons were made between the 2 groups(P<0.05).There were no significant differences in the levels of HR or MAP,when comparisons were made between the 2 groups at T0(P>0.05).The levels of HR and MAP in the experimental group at T1,T2,and T3 were significantly lower than those in the control group(P<0.05).The levels of HR and MAP at T1,T2,and T3 in the control group were significantly higher than those at T0(P<0.05).However,there were no significant differences in the levels of HR or MAP,when comparisons were made at different time points in the experience group(P>0.05).There were significant differences in VAS scores,when comparisons were made between different groups,at different time points,at different time points between groups(P<0.05).There were no significant differences in VAS scores,when comparisons were made between the 2 groups at T0(P>0.05).The VAS scores of the experimental group at T1,T2,and T3 were significantly lower than those of the control group(P<0.05),and the VAS scores of the 2 groups at T1,T2,and T3 were significant differences lower than those at T0(P<0.05).The effective anesthetic rate of the experimental group was 95.00%and that of the control group was 82.50%,with statistical significance,when comparisons were made between the 2 groups(P<0.05).There were no singificant differences in the incidences of phrenic nerve block,recurrent laryngeal nerve block,or Horner syndrome,when comparisons were made between the 2 groups(P>0.05).The incidence of vascular injury in the experience group was significantly lower than that in the control group(P<0.05).Conclusion The application of cervical plexus C4 transverse process block one-point method under ultrasound guidance in clavicular fracture internal fixation can shorten the completion time of nerve block,maintain hemodynamic stability,improve analgesic effect,with good anesthetic effects.Furthermore,it can reduce the incidence of adverse reactions of vascular injury.
