Anaesthetic effects of dexmedetomidine combined with suprascapular and axillary nerve block anesthesia in shoulder arthroscopy surgery
ZHANG Shufeng1, ZHANG Xumei1, YUAN Li2, HUANG Chuanyu1, JI Mingming1, LIU Jingjing1
1. Department of Anesthesiology, Beijing Municipal Corps Hospital of Chinese People′s Armed Police Force, Beijing 100027, China; 2. Department of Anesthesiology, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, China
摘要目的 探讨右美托咪定联合肩胛上神经和腋神经阻滞麻醉对肩关节镜手术的效果。方法 选取2021-01至2023-01在武警北京总队医院和河北北方学院附属第一医院行肩关节镜手术治疗的患者122例为研究对象,根据麻醉方法不同,并按照年龄相差1岁和性别相同原则进行1∶1的比例配对,分为右美托咪定组和全麻组,每组61例。对两组患者一般资料、术中血流动力学、脑血氧饱和度、术后疼痛评分及并发症情况进行比较。结果 右美托咪定组麻醉持续时间为(113.41±17.45) min,麻醉恢复室监测时间为(23.12±6.27) min,均短于全麻组[(127.94±18.42)min 和(29.17±6.49 min)],差异均有统计学意义(P<0.05)。右美托咪定组麻醉后20 min至手术结束时脑氧饱和度、麻醉后10 min起平均动脉压均高于全麻组,差异有统计学意义(P<0.05)。术后12 h疼痛VAS评分(2.50±0.41)低于全麻组(3.16±0.71,P<0.05)。与全麻组相比,右美托咪定组使用升压药比例更低(6.56% vs. 49.18%),发生低氧血症(11.48% vs. 32.79%)及采用辅助呼吸例数更少(9.84% vs. 34.43%),术后恶心呕吐发生率低(32.79% vs. 68.85%),差异均有统计学意义(P<0.05)。结论 右美托咪定联合肩胛上神经阻滞和腋神经阻滞麻醉对肩关节手术麻醉和镇痛效果良好,术中具有较好的血流动力学稳定性,安全性高。
Abstract：Objective To investigate the effects of dexmedetomidine combined with suprascapular and axillary nerve block in shoulder arthroscopy surgery. Methods The clinical data of 122 patients who received shoulder arthroscopy from January 2021 to January 2023 in Beijing Municipal Corps Hospital of Chinese People’s Armed Police Force were retrospectively analyzed, and the patients were divided into the dexmedetomidine group (n=61) and the general anesthesia group (n=61) according to their different anesthesia methods and the principle of age difference of 1 year and gender parity. The general information, intraoperative hemodynamics, cerebral oxygen saturation, postoperative pain score, and complications between the two groups were compared. Results The anesthesia duration (113.41±17.45 min) and anesthesia recovery room monitoring time (23.12±6.27 min) of the dexmedetomidine group (29.17±6.49 min and 29.17±6.49 min) were shorter than those of the general anesthesia group (P<0.05). From 20 minutes after anesthesia to the end of the operation, the cerebral oxygen saturation in the dexmedetomidine group was higher than that in the general anesthesia group (P<0.05). The mean arterial pressure in the dexmedetomidine group was higher than that in the general anesthesia group from 10 min after anesthesia (P<0.05). At 12 h after surgery, the VAS scores of the dexmedetomidine group (2.50±0.41) were lower than that in the general anesthesia group (3.16±0.71) (P<0.05). Compared with the general anesthesia group, the dexmedetomidine group had a lower proportion of patients with vasopressor drugs (6.56% vs. 49.18%), hypoxemia (6.56% vs. 49.18%), assisted breathing (9.84% vs. 34.43%), and a lower incidence of postoperative nausea and vomiting (32.79% vs. 68.85%) (P<0.05). Conclusions Dexmedetomidine combined with suprascapular and axillary nerve block has better anesthetic and analgesic effects in shoulder arthroscopy surgery, and has good hemodynamic stability and high safety.
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2023, Vol. 34 
