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- Title
B超声引导下肋锁间隙与喙突入路连续臂丛神经阻滞对Barton骨折术后镇痛效果比较.
- Authors
殷国江; 阮剑辉; 周翔; 胡光俊; 宋晓阳; 夏中元
- Abstract
Objective: To compare the postoperative analgesia of patients who take either ultrasound-guided costoclavicular space approach or coracoid approach of continuous infraclavicular brachial plexus block anesthesia undergoing Barton's fracture surgery. Sixty patients ( ASA Ⅰ ~ Ⅱ) with Barton's fractures were randomly divided into two groups: group A and group B (n=30 each). Group A received continuous brachial plexus block via costoclavicular space approach under ultrasound guidance, group B received continuous brachial plexus block via coracoid approach under ultrasound guidance. Nerve block catheters were indwelling in both groups, wireless electronic analgesia pump were connected to the nerve block catheter 2 hours after anesthesia. The nerve depth, operation time of anesthesia and effect of anesthesia were recorded. The first additional drug time after surgery were recorded. The resting and motor status VAS scores at 6 h, 12 h, 18 h, 24 h, 36 h, 48 h after anesthesia were recorded. The number of effective presses of analgesic pumps and the remedial analgesia on the first and second day after surgery were recorded. The patients' satisfaction score and complications were recorded. Results: The nerve depth of group A was shallower than that of group B (P<0.05); the operation time of anesthesia in group A was shorter than that of group B (P<0.05). Compared with group B, the first postoperative addition time of group A was significantly longer (P<0.05), and the scores of rest and motor VAS in group A were significantly lower at 12 h, 18 h, 24 h, 36 h after anesthesia (P<0.05). The number of effective compressions in group A was significantly less than that in group B on the first day after surgery (P<0.05), and Patient satisfaction score of group A was higher than that in group B (P<0.05). The incidence of accidental vascular puncture in group A was significantly lower than that in group B (P<0.05). Conclusion: Ultrasound-guided costoclavicular space continuous brachial plexus block and coracoid approach continuous infraclavicular brachial plexus block could be safely and effectively used in postoperative analgesia of Barton's fractures. However the costoclavicular space continuous brachial plexus block has a better postoperative analgesic effect and more advantages of superficial nerve position, convenient operation, high patient satisfaction and less complications.
- Subjects
BRACHIAL plexus block; NERVE block; IMPLANTABLE catheters; PATIENT satisfaction; CONTINUOUS groups; ANALGESIA
- Publication
Progress in Modern Biomedicine, 2020, Vol 20, Issue 2, p285
- ISSN
1673-6273
- Publication type
Article
- DOI
10.13241/j.cnki.pmb.2020.02.017