用于中心静脉导管插入术的中层和表层颈丛神经阻滞的比较

Murat Sevim, Mahmut Sami Tutar, Betul Kozanhan
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引用次数: 0

摘要

目的比较浅层颈丛(SCP)和超声波(USG)引导的中层颈丛(ICP)阻滞对中心静脉导管插入术(CVC)中患者和操作者满意度的影响:实验研究。研究地点和时间:2022年5月至7月,土耳其科尼亚市科尼亚市医院麻醉与复苏科:80 名患者在 CVC 前被随机分配到 ICP 和 SCP 阻滞组。患者接受 10 毫升的局部麻醉。使用 10 点数字评分量表(NRS)评估插针、扩张、导管插入和缝合时以及术后 5 分钟的疼痛程度。术后 30 分钟,使用 5 点李克特量表对患者和操作者的满意度进行评估:结果:在进针、扩张和 CVC 术后 5 分钟内,ICP 阻断组的平均疼痛评分低于 SCP 阻断组(p = 0.022,p 结论:ICP 和 SCP 阻断组的平均疼痛评分均低于 SCP 阻断组:研究结果表明,ICP 和 SCP 阻滞在 CVC 过程中给患者和操作者带来的满意度相当。鉴于 ICP 阻滞在手术的各个阶段都会导致较低的疼痛评分,因此建议采用这种方法来提高患者的整体舒适度,并将 CVC 过程中的疼痛降至最低:中心静脉导管术 颈丛神经中段阻滞 颈丛神经浅层阻滞 患者满意度
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Comparison of Intermediate and Superficial Cervical Plexus Blocks for Central Venous Catheterisation.

Objective: To compare the effectiveness of the superficial cervical plexus (SCP) and ultrasonography (USG)-guided intermediate cervical plexus (ICP) blocks for patient and operator satisfaction during central venous catheterisation (CVC).

Study design: Experimental study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, between May and July 2022.

Methodology: Eighty patients were randomly assigned to the ICP and SCP block groups before CVC. Patients received 10ml of a local anaesthesia. Pain levels were assessed during needle insertion, dilation, catheter insertion, and suturing, and 5 minutes after the procedure using a 10-point numeric rating scale (NRS). Thirty minutes post-procedure, patient and operator satisfaction were evaluated using a 5-point Likert-type scale.

Results: The ICP block group had lower mean pain scores than the SCP block group during needle entry, dilation, and 5 minutes after CVC (p = 0.022, p <0.001, and p = 0.005, respectively). However, no significant differences were found in pain scores after the block application, during catheter insertion, and suturing (p = 0.279, p = 0.052, and p = 0.072, respectively). Patient and operator satisfaction scores did not significantly differ between the two groups (p = 0.189 and p = 0.329, respectively).

Conclusion: The study demonstrated that the ICP and SCP blocks resulted in comparable patient and operator satisfaction levels during CVC. Given that the ICP block resulted in lower pain scores at various stages of the procedure, it is a recommended method to enhance overall patient comfort and minimise the pain during CVC.

Key words: Central venous catheterisation, Intermediate cervical plexus block, Superficial cervical plexus block, Patient satisfaction.

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