Coracoid approach brachial plexus block combined with posterior suprascapular nerve block provides analgesia for shoulder arthroscopy: a randomized controlled trial.

IF 3.9 2区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Scientific Reports Pub Date : 2025-03-20 DOI:10.1038/s41598-025-93881-x

Wensheng He, Zhenyu Wu, Shan Su, Zengping Huang

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引用次数: 0

Abstract

Shoulder arthroscopy has become a common procedure, but it is often associated with severe postoperative pain. This study aims to evaluate the analgesic effect of ultrasound-guided coracoid approach brachial plexus block combined with posterior suprascapular nerve block in shoulder arthroscopy. To this end, fifty patients undergoing right shoulder arthroscopy were randomly divided into two groups with 25 patients in each group. Before induction of general anesthesia, patients in the two groups received different nerve blocks. In Group A, participants received ultrasound-guided supraclavicular brachial plexus block with 25 mL 0.3% ropivacaine. In Group B, coracoid approach brachial plexus block and posterior suprascapular nerve block were carried out under ultrasound guidance. M-mode ultrasound was used to measure diaphragm movement before and 30 min after the block, and the presence of hemidiaphragm paralysis was recorded during calm breathing and deep breathing. Pain scores were recorded at 1, 6, 12, 24 and 48 h after surgery. The actual press times of the PCA pump and consumption of sufentanil were also recorded.A total of 45 patients completed this study. The incidence of hemidiaphragm paralysis in Group B was significantly lower than that in Group A under both calm breathing and deep breathing. The two groups displayed similar pain scores at 1, 6, 12, 24 and 48 h after surgery. Compared with supraclavicular brachial plexus block, coracoid approach brachial plexus block combined with posterior suprascapular nerve block can significantly reduce the occurrence of hemidiaphragm paralysis with an equivalent postoperative analgesic effect for shoulder arthroscopy. Therefore, the latter may be beneficial for early postoperative recovery in patients who cannot tolerate hemidiaphragm paralysis. Trial registration: This study was registered in the Chinese Clinical Trial Register (ID ChiCTR2100043069) on 04/02/2021.

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喙突入路臂丛阻滞联合肩胛后上神经阻滞提供肩关节镜镇痛：一项随机对照试验。

肩关节镜检查已成为一种常见的手术，但它往往与严重的术后疼痛有关。本研究旨在评价超声引导下喙突入路臂丛阻滞联合肩胛上后神经阻滞在肩关节镜下的镇痛效果。为此，将50例接受右肩关节镜检查的患者随机分为两组，每组25例。在全麻诱导前，两组患者接受不同程度的神经阻滞。在A组，参与者接受超声引导下锁骨上臂丛阻滞25 mL 0.3%罗哌卡因。B组在超声引导下行喙突入路臂丛神经阻滞和肩胛后上神经阻滞。阻滞前、阻滞后30 min采用m型超声测量膈肌运动，静息呼吸、深呼吸时记录膈肌麻痹情况。分别于术后1、6、12、24、48 h记录疼痛评分。同时记录PCA泵的实际按压次数和舒芬太尼的用量。共有45名患者完成了这项研究。镇静呼吸和深呼吸两种呼吸方式下，B组半膈肌麻痹发生率均显著低于A组。两组患者术后1、6、12、24、48小时疼痛评分相近。与锁骨上臂丛神经阻滞相比，喙突入路臂丛神经阻滞联合肩胛后上神经阻滞可显著减少半膈肌麻痹的发生，肩关节镜术后镇痛效果相当。因此，后者可能有利于不能忍受半膈肌麻痹的患者术后早期恢复。试验注册：本研究已于2021年4月2日在中国临床试验注册中心（ID ChiCTR2100043069）注册。

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来源期刊

Scientific Reports Natural Science Disciplines-

CiteScore

7.50

自引率

4.30%

发文量

19567

审稿时长

3.9 months

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