静脉注射地塞米松联合超声引导肌间沟臂丛神经阻滞用于肩部手术的随机对照研究

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Abstract Objective To investigate the effects of intravenous injection of different doses of Dexamethasone combined with ultrasound-guided interscalene bronchial plexus block on postoperative analgesia in patients underwent shoulder surgery. Methods 80 cases of patients underwent shoulder arthroscopy under interscalene brachial plexus blockade in Yichang Central People's Hospital from June 2014 to October 2015 were chosen and randomly divided into four groups: intravenous injection of saline (group A, n=20), 0.025 mg/kg Dexamethasone (group B, n=20), 0.05 mg/kg Dexamethasone (group C, n=20), 0.1 mg/kg Dexamethasone (group D, n=20) before blockade, respectively. Outcomes for 48 h were recorded. Primary endpoint was the time to first postoperative analgesic required. No or mild pain at 24 h and 48 h, weakness at 24 h, cumulative analgesic consumption, sleep disturbance, nausea and vomiting, and satisfaction were considered as secondary outcomes. Results The median time to first postoperative analgesic required was significantly longer in group C and group D than that in group A (P < 0.01), but there was no significant difference between group C and group D (P > 0.05). Among the four groups, no or mild pain at 24 h and 48 h, weakness at 24 h, no analgesia required, the amount of Tramadol and Dolantin required were compared, there were no significant differences (P > 0.05), but the amount of Diclofenac Sodium Suppository was lower in group D than that in group A (P < 0.05). The incidence of sleep disturbance in group C and group D was less than that in group A (P < 0.05), and patients' anesthesia satisfaction rate in group D was higher than that in group A (P < 0.05). Conclusion Intravenous injection of 0.05 mg/kg or 0.1 mg/kg Dexamethasone can extend the duration of postoperative analgesia provided by interscalene brachial plexus block, patients' satisfaction with anesthesia by using 0.1 mg/kg Dexamethasone is higher.

Key words： Interscalene Plexus blockade Dexamethasone

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	LIN Lei1 CHEN Chun1 HOU Jun2 YANG Ping2

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LIN Lei1 CHEN Chun1 HOU Jun2 YANG Ping2. A randomised controlled trial of intravenous Dexamethasone combined with interscalene brachial plexus blockade guided by ultrasound in shoulder surgery[J]. 中国医药导报, 2017, 14(16): 67-70.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I16/67

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