Anaesthetic effects of dexmedetomidine combined with suprascapular and axillary nerve block anesthesia in shoulder arthroscopy surgery

ZHANG Shufeng; ZHANG Xumei; YUAN Li; HUANG Chuanyu; JI Mingming; LIU Jingjing

PDF(973 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2023, Vol. 34 ›› Issue (11) : 935-938.

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

Author information +

History +

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.

Key words

shoulder arthroscopy / nerve block / dexmedetomidine / suprascapular nerve / axillary nerve

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

ZHANG Shufeng, ZHANG Xumei, YUAN Li, HUANG Chuanyu, JI Mingming, LIU Jingjing. Anaesthetic effects of dexmedetomidine combined with suprascapular and axillary nerve block anesthesia in shoulder arthroscopy surgery[J]. Medical Journal of the Chinese People Armed Police Forces. 2023, 34(11): 935-938

References

[1] 韩增帅, 马温儒, 李天予, 等. 肩关节镜下外排锚钉压肌腱线与打结线治疗重度肩袖撕裂的疗效比较[J]. 中华创伤骨科杂志, 2021, 23(8):700-706.
[2] 黄峰,姜宁,毛瑞君, 等.关节镜下Twinfix锚钉治疗肩关节Bankart损伤48例[J].武警医学, 2022, 33(2):170-172.
[3] 任惠龙, 吴安石, 利雪阳. 超声引导下神经阻滞在肩关节镜手术中的应用进展[J]. 临床麻醉学杂志, 2021, 37(11):1212-1216.
[4] Abdallah F W, Wijeysundera D N, Laupacis A, et al. Subomohyoid anterior suprascapular block versus interscalene block for arthroscopic shoulder surgery: A multicenter randomized trial[J]. Anesthesiology, 2020, 132(4):839-853.
[5] 刘梦凡, 王秀丽. 肩关节镜手术沙滩椅位患者脑氧饱和度的研究进展[J]. 临床麻醉学杂志, 2023, 39(3):318-321.
[6] 赵霞, 周海滨, 郑少强, 等. 低浓度局部麻醉药物对肩关节镜患者肌间沟臂丛神经阻滞后膈肌功能的影响[J]. 重庆医学, 2022, 51(9):1549-1553.
[7] 李鑫, 华豪, 陈晓东, 等. 右美托咪定复合臂丛神经阻滞超前镇痛对关节镜下桡骨远端骨折术后镇痛、炎症反应和早期康复的影响[J]. 中国临床医生杂志, 2022, 50(4):474-477.
[8] 鲜于文翠, 方平, 孙佳晖, 等. 右美托咪定与艾司洛尔在肩关节镜术中控制性降压时对脑氧饱和度和认知功能的影响研究[J]. 实用药物与临床, 2023, 26(2):117-121.
[9] 刘梦凡, 王秀丽. 肩关节镜手术沙滩椅位患者脑氧饱和度的研究进展[J]. 临床麻醉学杂志, 2023, 39(3):318-321.
[10] Ding D Y, Mahure S A, Mollon B, et al.Comparison of general versus isolated regional anesthesia in total shoulder arthroplasty: A retrospective propensity-matched cohort analysis[J]. J Orthop, 2017, 14(4):417-424.
[11] 张文颉, 田首元, 王建刚, 等. 右美托咪定对大鼠心室肌细胞动作电位时程的影响及α₂受体在其中的作用[J]. 中华麻醉学杂志, 2017, 37(10):1247-1249.
[12] 李红英, 张建杏, 王研, 等. 右美托咪定对大鼠神经元缺氧无糖损伤保护作用的实验研究[J]. 中国临床解剖学杂志, 2014, 32(4):455-457.
[13] 邱丽, 杨扬, 邹小华. 超声诊断肌间沟臂丛神经阻滞后膈肌麻痹一例[J]. 临床麻醉学杂志, 2021, 37(9):1007-1008.
[14] 周阳洋, 张金祥, 袁红斌, 等. 超声引导下臂丛上干阻滞联合监护麻醉用于肩关节镜手术的效果[J]. 临床麻醉学杂志, 2021, 37(6):637-639.
[15] Lee M G, Shin Y J, You H S, et al.A comparison of anesthetic quality between interscalene block and superior trunk block for arthroscopic shoulder surgery: a randomized controlled trial[J]. Pain Physician, 2021, 24(3):235-242.
[16] Koh J L, Levin S D, Chehab E L, et al. Neer Award 2012: cerebral oxygenation in the beach chair position: a prospective study on the effect of general anesthesia compared with regional anesthesia and sedation[J]. J Shoulder Elbow Surg, 2013, 22(10):1325-1331.
[17] 陆筱星, 王凯, 周美艳, 等. 目标导向液体治疗在陈旧性脑梗死老年患者沙滩椅体位手术中的脑保护作用[J]. 中国医药导报, 2022, 19(25):98-102.
[18] 宋慧娟, 胡媛媛, 童蕾, 等. 局部脑氧饱和度目标导向管理对老年脊柱手术患者术后早期神经认知障碍的影响[J]. 中国医师杂志, 2021, 23(7):1012-1016.
[19] 郭云飞, 魏雯欣, 胡楠楠, 等. 右美托咪定对腹腔镜肝切除术老年患者脑氧饱和度及术后认知的影响[J]. 河北医学, 2022, 28(6):1011-1016.