Effects of ultrasound-guided intermuscular brachial plexus anesthesia on shoulder arthroscopic surgery
10.3760/cma.j.cn341190-20240509-00537
- VernacularTitle:超声引导下肌间臂丛麻醉用于肩关节镜手术的效果观察
- Author:
Lingyun GE
1
;
Min LUO
Author Information
1. 东阳市中医院麻醉科，东阳 322100
- Publication Type:Journal Article
- Keywords:
Brachial plexus block;
Anesthesia, general;
Endoscopy;
Anesthesia and analgesia;
Ultrasonography, interventional;
Shoulder joint;
Blood pressure;
Hemodynamic
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(2):204-209
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of ultrasound-guided intermuscular brachial plexus anesthesia on shoulder arthroscopic surgery.Methods:A total of 300 patients who underwent shoulder arthroscopic surgery at Dongyang Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were prospectively included in this study. A randomized controlled trial design was used. The patients were divided into an observation group ( n = 150) and a control group ( n = 150) using a random number table method. The control group received intravenous general anesthesia, while the observation group underwent intermuscular brachial plexus nerve block combined with intravenous general anesthesia. The clinical efficacy, surgical indicators, hemodynamic levels, and incidence of adverse reactions were compared between the two groups. Results:The Visual Analog Scale (VAS) scores and the muscle strength scores for elbow and wrist flexion in the observation group at 2 and 3 h postoperatively were (4.12 ± 0.21), (2.32 ± 0.62), (3.35 ± 0.61), and (4.19 ± 0.57), respectively. There values were significantly superior to those in the control group [(6.54 ± 0.32), (1.21 ± 0.23), (4.62 ± 0.21), (3.25 ± 0.63), t = 77.44, 20.56, -24.11, 13.55, all P < 0.01]. The intraoperative lavage fluid volume, remifentanil dosage, propofol dosage, and duration of surgery in the observation group were (6.32 ± 2.11) L, (0.13 ± 0.03) μg·kg?1·min?1, (0.11 ± 0.03) mg·kg?1·h?1, and (73.23 ± 15.86) min, respectively, all of which were significantly lower than those in the control group [(8.52 ± 3.23) L, (0.15 ± 0.02) μg·kg?1·min?1, (0.15 ± 0.02) mg·kg?1·h?1, and (79.88 ± 15.56) min, t = 6.98, -6.79, -13.59, -3.67, all P < 0.01]. The clarity of the surgical field in the observation group was rated at (1.02 ± 0.21) points, which was significantly higher than that in the control group [(1.75 ± 0.32) points, t = -23.36, P < 0.01]. At the start of surgery (T1) and 30 min into the procedure (T2), the systolic blood pressures in the observation group were (106.65 ± 7.12) mmHg (1 mmHg = 0.133 kPa) and (97.02 ± 5.01) mmHg, which were significantly lower than those in the control group [(108.69 ± 7.21) mmHg, (98.26 ± 5.12) mmHg, t = -2.47, -2.12, both P < 0.05]. The heart rates in the observation group at T1, T2, 60 min into the procedure (T3), and 10 min post-extubation (T4) were (71.69 ± 5.32) beats/min, (62.32 ± 4.85) beats/min, (61.12 ± 4.25) beats/min, and (79.28 ± 3.52) beats/min, all of which were significantly lower than those in the control group [(91.23 ± 5.21) beats/min, (90.12 ± 4.63) beats/min, (92.21 ± 4.31) beats/min, (92.32 ± 3.51) beats/min, t = -32.14, -50.78, -62.91, -32.13, all P < 0.01]. The total incidence of adverse reactions, including allergies, nausea, vomiting, and dizziness, in the observation group was 28.67% (43/150), which was significantly lower than that in the control group [45.33% (68/150), χ2 = 8.94, P < 0.01]. Conclusions:Ultrasound-guided intermuscular brachial plexus anesthesia improves intraoperative anesthetic effects, reduces the volume of lavage fluid, remifentanil, and propofol used, shortens duration of surgery, and enhances the clarity of the surgical field. Additionally, it also effectively controls blood pressure and hemodynamic changes, leading to a reduction in adverse reactions.
