目的:尽管超声引导下的周围神经阻滞越来越流行,目前,超声引导是否是周围神经阻滞的必要工具仍有争议。这项研究的目的是评估超声引导下周围神经阻滞在减少并发症中的意义。
方法:从2013年1月至2019年1月,回顾了17,823例接受或不接受超声引导的周围神经阻滞的患者,记录他们年龄的数据,性别,高度,体重,美国麻醉医师协会,块类型,操作类型,操作持续时间,和并发症。将患者分为超声引导组(US组)9372例和无超声引导组(非US组)8451例。为了控制选择偏差,共有16,236例患者在1:1倾向评分匹配后最终纳入本研究,包括美国集团的8118例和美国集团的8118例。结果指标包括局部麻醉全身毒性(LAST),神经损伤,不完全阻滞麻醉(IBA),局部血肿,和阻塞部位的感染。
结果:两组患者的基线特征相似(分别为P>.05)。我们的研究表明,两组之间的感染发生率相似(P>.05)。然而,最后的发生率,神经损伤,IBA,US组局部血肿明显低于非US组(P<0.05)。
结论:我们的研究结果表明,超声引导下的周围神经阻滞与更少的并发症和更高的成功率相关。与感觉异常方法相比。
OBJECTIVE: Although ultrasound-guided peripheral nerve blocks have become increasingly popular, it is arguable at present whether ultrasound guidance is a necessary tool for peripheral nerve blocks. The purpose of this study was to assess the significance of ultrasound-guided peripheral nerve blocks in reducing complications.
METHODS: From January 2013 to January 2019, 17,823 patients who underwent peripheral nerve blocks with/without ultrasound guidance were reviewed, recording data on their age, sex, height, weight, American Society of Anesthesiologists, block type, operation type, operation duration, and complications. The patients were divided into 2 groups: 9372 cases with ultrasound guidance (US Group) and 8451 cases without ultrasound guidance (No-US Group). To control selection bias, a total of 16,236 patients were finally included in this study after 1:1 propensity score matching, including 8118 cases in the US Group and 8118 cases in the No-US Group. Outcome measures included local anesthetic systemic toxicity (LAST), nerve injury, incomplete block anesthesia (IBA), local hematoma, and infection at the block site.
RESULTS: Baseline characteristics of patients were similar between the two groups (P >.05, respectively). Our study revealed that the incidence of infection was similar between the two groups (P >.05). However, the incidences of LAST, nerve injury, IBA, and local hematoma in the US Group were significantly lower than those in the No-US Group (P <.05, respectively).
CONCLUSIONS: Our findings suggest that ultrasound-guided peripheral nerve blocks are associated with fewer complications and higher success rates, compared with the paresthesia approach.