目的 探讨超声引导下冈下肌小圆肌筋膜间阻滞（infraspinatus-teres minor interfascial block， ITMIB）用于肩关节镜手术患者的术后镇痛效果，并评价其对膈肌功能、运动恢复及不良反应的影响。 方法 选取2024年5月至2025年2月在中山市中医院行肩关节镜肩袖修补术患者80例，随机分为冈下肌小圆肌筋膜间阻滞组（A组，n = 40）和肌间沟臂丛神经阻滞组（B组，n = 40）。两组均使用0.375%罗哌卡因20 mL行超声引导阻滞后复合全麻。比较两组患者离开PACU时、术后2、6、12及24 h的静息VAS评分、膈肌麻痹发生率、患肢感觉与运动功能恢复情况及不良反应。 结果 A组4例因阻滞效果未达预期被剔除，最终A组36例，B组40例纳入分析。两组在术后6、12、24 h时间点静态VAS评分差异无统计学意义（P > 0.05），在PACU、术后2 h时间点A组VAS评分高于B组（P < 0.05）。A组术后2 h内氟比洛芬酯用量高于B组（P < 0.05）。在阻滞后30 min时刻，A组半膈肌麻痹发生率（0%）显著低于B组（90%）（P < 0.05），且患侧肢体麻木程度更轻（P < 0.05）；与B组相比，A组离开PACU时、术后6 h时间点前臂肌力更高（P < 0.05）。A组阻滞过程中有异感发生率低于B组（P < 0.05）。 结论 ITMIB用于肩关节镜手术，术后镇痛早期效果略差，后期效果相当，可避免膈肌麻痹，促进患肢运动功能早期恢复，不增加不良反应风险，尤其适用于合并呼吸系统疾病患者。

Objective To investigate the postoperative analgesic efficacy of ultrasound-guided infraspinatus-teres minor interfascial block （ITMIB） in patients who undergo arthroscopic shoulder surgery and to evaluate its impact on diaphragmatic function， motor recovery， and adverse effects. Methods Eighty patients who underwent arthroscopic rotator cuff repair at Zhongshan Hospital of Traditional Chinese Medicine between May 2024 and February 2025 were randomly allocated into the infraspinatus-teres minor interfuscial block group （Group A， n = 40） and the interscalene brachial plexus block group （Group B， n = 40）. Both groups received ultrasound-guided nerve block using 20 mL of 0.375% ropivacaine in combination with general anesthesia. A comparison was made between the two groups regarding resting VAS scores at various postoperative time points， the incidence of diaphragmatic paralysis， the recovery of sensory and motor function in the affected limb， and adverse reactions. Results Four cases in Group A were excluded from the analysis because of insufficient block efficacy， resulting in 36 cases in Group A and 40 cases in Group B available for analysis. There were no significant differences in static Visual Analog Scale （VAS） scores at 6 h， 12 h， and 24 h post-operatively （P > 0.05）. Nevertheless， Group A exhibited higher VAS scores in the Post-Anesthesia Care Unit （PACU） and at 2 h post-operatively compared with Group B （P < 0.05）. Moreover， Group A required a greater amount of flurbiprofen axetil within the first 2 h （P < 0.05）. At T1 （post-block assessment）， the incidence of hemidiaphragmatic paralysis was significantly lower in Group A （0%） than in Group B （90%） （P < 0.05）， and the degree of limb numbness was milder in Group A （P < 0.05）. Additionally， the forearm muscle strength was higher in Group A at T5 and T7 （P < 0.05）. The incidence of paresthesia during block placement was lower in Group A （P < 0.05）. Conclusions For patients undergoing arthroscopic shoulder surgery， ITMIB offers marginally less effective analgesia during the early postoperative period； however， it attains comparable pain relief thereafter. Moreover， it prevents diaphragmatic paralysis， promotes the early restoration of motor function in the affected limb， and does not elevate the risk of adverse reactions. These characteristics render it especially appropriate for patients with respiratory comorbidities.