背景:在本研究中,使用界标引导法评估浅表颈丛阻滞(SCPB)的优势.我们的主要目的是通过观察全身镇痛药总剂量的术中和术后需求来评估SCPB在各种头颈部手术中的镇痛效果。视觉模拟量表(VAS)评分,和镇痛的总持续时间;也观察了重要参数和相关的围手术期并发症。
方法:使用MedCalc软件v.19.5.1(MedCalc软件,奥斯坦德,比利时)两组之间的平均得分差异为3±3.5,80%功率,95%置信区间(CI);每组样本量为21。ASAⅠ组每组30例,II,和III被张贴在下颌骨上,鼓膜乳突和锁骨手术。A组接受全身麻醉和全身镇痛,B组接受全身麻醉,然后根据手术部位分别注射SCPB,每侧注射0.25%布比卡因10ml。VAS评分,24小时内和术后镇痛需求,第一次需求推注的时间,并注意到围手术期并发症。
结果:与B组相比,A组术中芬太尼需求量为97.5±13.75µg(70.16±13.09µg),与B组(833.33±874.28mg)相比,A组(2566.66±504mg)的术后对乙酰氨基酚注射需求也显著增加.与A组(122.0±50.88分钟)相比,B组的镇痛总持续时间(1191.33±375.36分钟)明显更高,p值<0.0001。所有患者均未出现明显并发症。
结论:SCPB通过减少术中和术后全身镇痛需求及其相关副作用,提供更好的围手术期镇痛。各种头颈部手术均无明显围手术期并发症。
BACKGROUND: In the present study, the advantages of superficial cervical plexus block (SCPB) were evaluated using a landmark-guided method. Our primary aim was to evaluate the analgesic efficacy of SCPB in various head and neck surgeries by observing intra- and postoperative requirements of the total dose of the systemic analgesic, visual analog scale (VAS) score, and the total duration of analgesia; vital parameters and associated perioperative complications were also observed.
METHODS: Sample size was calculated using reference by taking the parameter pain score at 12 hours using MedCalc software v. 19.5.1 (MedCalc Software, Ostend, Belgium) with a mean difference of score 3±3.5 between two groups, 80% power, and 95% confidence interval (CI); the sample size for each group was 21. There were 30 patients in each group of ASA I, II, and III who were posted for mandibular, tympanomastoid and clavicular surgeries. Group A received general anaesthesia with systemic analgesia and Group B received general anaesthesia followed by SCPB with an injection of bupivacaine 0.25% 10ml on each side according to the site of surgery. VAS score, intra and postoperative analgesic requirement in 24 hours, time of first demand bolus, and peri-operative complications were noted.
RESULTS: Intraoperative fentanyl requirement for group A was 97.5±13.75 µg as compared to group B (70.16±13.09 µg), postoperative injection paracetamol requirement was also significantly higher in group A (2566.66±504 mg) as compared to group B (833.33±874.28 mg). The total duration of analgesia was significantly higher in Group B (1191.33±375.36 min) as compared to Group A (122.0±50.88 min) with a p-value <0.0001. No significant complications were noted in any patient.
CONCLUSIONS: SCPB provides better perioperative analgesia by decreasing intraoperative as well as postoperative systemic analgesic requirements and their associated side effects, with no significant perioperative complications in various head and neck region surgeries.