Abstract:Objective: To investigate the effect of ultrasound-guided scapular dorsal nerve (DSN) block combined with general anesthesia on postoperative analgesia of scapular fracture. Methods: A total of 152 patients with scapular fracture who were admitted to our hospital from March 2018 to October 2021 for surgical treatment were selected. The patients were divided into control group and observation group by random number table method, with 76 cases in each group. The control group was treated with scapular internal fixation under general anesthesia, while the observation group was treated with DSN block combined with general anesthesia under ultrasound guidance. The differences of operation time, recovery time, utilization rate of vasoactive drugs, amount of remifentanil used during operation, postoperative analgesic remedy times, postoperative rehabilitation exercise time, pain degree, range of motion of shoulder joint and complications were compared between the two groups. Results: The time of postoperative awakening, the amount of remifentanil, the number of postoperative analgesia, the amount of sufentanil and the time of postoperative rehabilitation exercise in the observation group were all lower than those in the control group (P<0.05). VAS scores in both groups decreased gradually (P<0.05), and passive flexion, extension, internal rotation and external rotation of shoulder joint increased gradually (P<0.05). VAS scores of the observation group at 4h (T0), 8h (T1), 16 h (T2), 24h (T3) and 48h (T4) were lower than those of the control group (P<0.05). The activity of passive flexion, extension, internal rotation and external rotation in the observation group was greater than that in the control group at T3, 36h (M0), T4 and 72h (M1) postoperatively (P<0.05). There was no significant difference in complications between the two groups (P>0.05). Conclusion: DSN block combined with general anesthesia under ultrasound guidance can reduce postoperative pain degree of scapular fracture patients, shorten the start time of postoperative shoulder rehabilitation exercise, and increase the passive motion of shoulder joint, which is safe and reliable.
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