【原】[罂粟摘要]比较肌间沟阻滞和锁骨上阻滞对患者肺功能的影响: 单中心、双盲、随机试验

比较肌间沟阻滞和锁骨上阻滞对患者肺功能的影响: 单中心、双盲、随机试验

贵州医科大学     麻醉与心脏电生理课题组

翻译 :  安丽    编辑 :  严旭    审校 :  曹莹

背景:锁骨上神经丛阻滞(supraclavicular plexus block, SCB)和肌间沟神经丛阻滞(interscalene plexus block, ISB)对肺功能有潜在影响，持续时间尚不确定。因此，我们比较了SCB和ISB对肺功能的影响，尤其是持续时间。

方法：96例患者随机分为肌间沟神经丛阻滞组(I组)和锁骨上神经丛阻滞组(S组)，麻醉诱导前均在超声引导下行ISB和SCB。由研究者分别于阻滞前(T₀)、阻滞后30 min (T_{30 min})、4h(T_4h)、8h(T_8h)、12h(T_12h)时记录膈肌活动度和呼吸功能测试指标。计算上述时点膈肌麻痹的发生率。记录VAS评分、感觉和运动阻滞恢复时间及给药后24h内不良反应发生情况。

结果:I组膈肌活动度恢复时间长于S组。与I组相比，S组在阻滞后T30 min和T8h的正常呼吸时膈肌麻痹的发生率明显降低(P<0.05)。同样，S组在阻滞后T30 min、T8h和T12h深呼吸时膈肌麻痹的发生率明显降低。I组FEV1和FVC恢复时间长于S组。其余结果差异均无统计学意义。

结论：超声引导下ISB对肺功能的抑制时间长于SCB。

原始文献来源 ：

Jiajia Wang, Xinwei Hou, Xiao Zhang, Xueting Wang, Weiwei Qin, Qiujie Li,Fuguo Ma and Lixin Sun. Comparison of pulmonary function during interscalene block vs. supraclavicular block: a single-center, double-blind, 

Randomizedtrial.BMCAnesthesiology.(2023)23:12.Doi.org/10.1186/s12871-022-01967-0.

英文原文

Comparison of pulmonary function during interscalene block vs. supraclavicular block: a single-center, double-blind, 

randomized trial

Abstract 

Background: The supraclavicular plexus block (SCB) and interscalene plexus block (ISB) have the potential to pulmonary function, the duration of the potential remains uncertain. So, we compared the efect of SCB and ISB on pulmonary function, especially the duration time.

Methods: Ninety-six patients were fnally allocated to group I and group S. The ISB and the SCB procedures were performed with ultrasound guidance before anesthesia induction. An investigator recorded the diaphragm mobility and respiratory function test indicators before the block (T₀) and at 30 min (T_{30 min}), 4 h (T₄), 8 h (T₈), and 12 h (T₁₂) after the block. The diaphragmatic paralysis rate was calculated for above timepoint. The VAS, the recovery time for the sensory and motor block, and adverse reactions within 24 h of administering the block were also recorded.

Results: The recovery times of diaphragm mobility in group I were longer than those in group S. Compared with group I, group S had a signifcantly lower diaphragmatic paralysis rate during eupnea breathing at T₃₀ min and T8 after the block. Similarly, group S had a signifcantly lower diaphragmatic paralysis rate at deep breathing at T_{30 min}, T₈, and T₁₂ after the block. The recovery times of FEV₁ and FVC in group I were longer than those in group S. The other results were not statistically signifcant.

Conclusions: Ultrasound-guided ISB resulted in a longer periods with a suppressive efect on pulmonary function than SCB.

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