Effect of ultrasound-guided combined blockade of brachial plexus and paravertebral block for postopera-tive analgesia in patients with fracture of scapula / 临床麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of ultrasound-guided combined blockade of bra-chial plexus and paravertebral block for postoperative analgesia in patients undergoing internal fixation of scapular fracture.Methods Sixty patients,48 males and 12 females,ASA physical Ⅰ or Ⅱ,who were scheduled to undergo internal fixation of scapular fracture were enrolled in the study,and ran-domized into two groupsgroup B (combined blockade of brachial plexus and paravertebral block) and group C (regular control).Patients in B group received combined blockade of brachial plexus nerve block (interscalene or supraclavicular blocks)and paravertebral block (in C7-T1 ,T2-T3 and T4-T5 levels),and underwent the procedure with general anesthesia 30 min later.Surgery for patients in group C were performed under general anesthesia without a previous nerve block.Following data were collectedconsumption of sufentanil during surgery;agitation and length of stay in post-anesthesia care unit (PACU);complaint of pain and the need for supplemental analgesia in PACU;anesthesia-related complications such as nausea,vomiting,depression of respiration and retention.Results The mean total consumption of sufentanil was significantly increased in group C [(43.2 ± 7.1 )μg vs (12.3±5.2)μg,P <0.05];the length of stay,ratio of complaint of pain and need for supplemental analgesia in PACU were increased in group C (P <0.05).There was no statistical difference in post-operative complications.Conclusion We demonstrated that ultrasound-guided combined blockade of brachial plexus and paravertebral block provided feasible and reliable analgesia for patients underwent internal fixation of scapular fracture.