The Application Of Superior Trunk Of Brachial Plexus And Superficial Cervical Plexus Block By Ultrasound-guided Combined With General Anesthesia In Arthroscopic Shoulder Surgery

Objective:This study was designed to compare the efficacy between superior trunk of brachial plexus and superficial cervical plexus block by ultrasound-guided combined with general anesthesia and traditional interscalene brachial plexus block by ultrasound-guided combined with general anesthesia in arthroscopic shoulder surgery.The purpose of this study was to evaluate the value of modified regional nerve block combined with general anesthesia in arthroscopic shoulder surgery.Methods:A total of 90 ASA physical status I^?patients scheduled for arthroscopic shoulder surgery were enrolled and randomly assigned to 3 groups.Patients in group A received general anesthesia only.Group B were given traditional ultrasound-guided interscalene brachial plexus block before general anesthesia.Group C were given ultrasound-guided modified superior trunk of brachial plexus and superficial cervical plexus block before general anesthesia.Group B and group C used 0.35%ropivacaine for regional nerve block.The MAP and HR before the surgery?T₀?,5min after the beginning of the surgery?T₁?,30min after the beginning of the surgery?T₂?,and 30min after removing the laryngeal mask?T₃?were all recorded.The BIS of the three groups were maintained between 45 and 60.The BIS 5min after the beginning of the surgery,30min after the beginning of the surgery,the operation time,the extubation time?the time from stopping using sevoflurane to removing the laryngeal mask?,dosage of opioids?sufentanyl?,dosage of sevoflurane were all recorded.The VAS scores,muscle strength grades of elbow flexion and wrist flexion at PACU,6h after the surgery,12h after the surgery,dosage of analgesic drugs at 6h after the surgery,nausea,vomit,respiratory depression were all analyzed.Results:?1?Compared with group A,patients in group B,group C had significantly lower arterial blood pressure and heart rate at T1,T2,T3?P<0.05?,expressively shorter extubation time?P<0.05?,lower dosage of sufentanyl?P<0.05?,lower dosage of sevoflurane?P<0.05?,lower VAS scores at PACU,6h after the surgery,12h after the surgery?P<0.05?,lower muscle strength grades of elbow flexion at PACU?P<0.05?,lower dosage of analgesic drugs at 6h after the surgery?P<0.05?.Compared with group A,patients in group B had lower muscle strength grades of elbow flexion and wrist flexion at PACU,6h after the surgery?P<0.05?.?2?Compared with group B,patients in group C had significantly lower dosage of sevoflurane?P<0.05?,higher muscle strength grades of elbow flexion and wrist flexion at PACU,6h after the surgery?P<0.05?.Conclusion:Compare to ultrasound-guided traditional interscalene brachial plexus block combined with general anesthesia,ultrasound-guided modified superior trunk of brachial plexus and superficial cervical plexus block combined with general anesthesia can be helpful for the maintenance of intraoperative anesthesia depth,achieve a better management of controlled hypotension,reduce the dosage of intraoperative anesthetic drugs and postoperative analgesic drugs,relieve postoperative pain,decrease the incidence of postoperative adverse reactions and reach less musclular blockade of elbow flexion and wrist flexion in arthroscopic shoulder surgery.It is helpful for patients to recover quickly after operation.