SO SÁNH HIỆU QUẢ PHONG BẾ ĐÁM RỐI THẦN KINH ĐƯỜNG LIÊN CƠ BẬC THANG VỚI PHONG BẾ THẦN KINH TRÊN VAI PHỐI HỢP THẦN KINH NÁCH DƯỚI HƯỚNG DẪN SIÊU ÂM CHO PHẪU THUẬT KHỚP VAI

Abstract

Objective: To compare the analgesia effect during and after surgery of brachial plexus nerve blocking at the interscalene line and suprascapular nerve combined with axillary nerve blocking with ropivacaine 0.25%. Method: Prospective intervention, comparing 60 patients receiving regional anesthesia for shoulder arthroscopy and randomly divided into 2 groups: Group 1: 30 patients receiving 10 ml ropivacaine to the supraclavicular nerve and 10 ml of 0.25% ropivacaine to the axillary nerve under ultrasound guidance pre-anesthesia. Group 2: 30 patients were injected with 20 ml of ropivacaine 0.25% into the brachial plexus at the interscalene line under ultrasound guidance pre-anesthesia. Results: There was a difference in the onset of action of the suprascapular nerve combined with axillary nerve blocking group (group 1) and the brachial plexus block group on the interscalene line (group 2) (5 ± 0.7 vs 3 ± 0.5 min). There was also a difference in the amount of Fentanyl analgesic used in surgery (0.2 ± 0.06 mg in group 1 and 0.16 ± 0.04 mg in group 2). There was no difference in intraoperative hemodynamic parameters between the 2 study groups (p < 0.05). Group 1 has an advantage over group 2 in terms of VAS scores after surgery, time required for the first dose of morphine, and the amount of morphine needed after surgery. However, there was no difference in the total amount of morphine required. Conclusion: The analgesic effect and the intraoperative amount of morphine required by the supraclavicular nerve combined with the axillary nerve blocking was inferior to that of the brachial plexus blocking in the interscalene line but the there was no different in total amount of morphine required was.