The Effect Of Ultrasound Combined With Nerve Stimulator On The Analgesia After Frozen Shoulder Arthroscopy By Intermuscular Groove Brachial Plexus Block

Objective: To investigate and analyse the analgesia effect of continuous interscalene postoperative analgesia guided by ultrasonic combined with nerve stimulator in preoperative Frozen Shoulder patients with arthroscopic surgery.Methods: From September 2014 to March 2015,70 Frozen Shoulder patients(ASA?-?,41 male,29 female) treated with arthroscopic shoulder surgery with tracheal intubation general anesthesia were randomly divided into two groups. Experimental group(group T,19 male,16 female):a catheter was placed in interscalene by ultrasonic combined with nerve stimulator, the analgesic was gived by the catheter as auxiliary anesthesia continuously during operation and postoperation. Control group(group C, 22 male, 13 female): analgesic drugs was injected by intravenous administration through drug infusion pump. The time of postoperative administration is 20 minutes. To observe patients' static and dynamic(passive proneness on 90 °) pain score(VAS) at 2 h(H2), 6 h(H6), 12 h(H12), 24 h(H24), 48 h(H48) postoperative in two groups. To observe patients' compliance of early functional exercise, the incidence of major complication(nausea and vomiting, the nerve injury symptoms, skin itching, sleepiness), functional recovery level of lift on postoperative shoulder joint proneness and side outreach, and the fee of postoperative analgesia in two groups.Results: 1. VAS score: Under the static state, VAS score of each time was not significantly different between two groups of patients(P > 0.05).Under the dynamic state, VAS score of H2, H48 was not significantly different between two groups of patient s(P > 0.05), and VAS score of H6, H12 and H24 was significantly different between two groups of patients(P < 0.05). 2. The compliance of patients with early functional exercise: the compliance of two groups was significantly different, group T is better than that of group C(P < 0.05). 3. Complications: nausea and vomiting: the incidence of group T was 20%, the incidence of group C was 42.6%, with significant difference(P < 0.01);Paresthesia: 1 case of group T, patients with upper transient local skin numbness, a rate of 2.8%, the incidence of group C was 0%, there was not significantly different(P > 0.05); the incidence of skin itch of group T was 0%, the incidence of group C was 11.7%, the difference was statistically significant(P < 0.05); the incidence of drowsiness of group T was 0%, 14.7% incidence of group C, the difference was statistically significant(P < 0.05).Conclusion: Continuous interscalene postoperative analgesia guided by ultrasonic combined with nerve stimulator can effectively alleviate the pain of early postoperative functional exercise of the patients treated with arthroscopic shoulder surgery, improve the compliance of patients with early functional exercise, reduce the incidence of postoperative complications, promote patients to do postoperative functional exercise earlier, improve the function of shoulder joint, and improve patients' satisfaction.