超声引导定位行肌间沟臂丛神经阻滞的麻醉效果
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摘要
目的探讨超声引导定位行肌间沟臂丛神经阻滞的麻醉效果。方法在医院2015年1月—2018年6月期间诊治的行臂丛神经阻滞患者中选取60例作研究对象,并按定位方式不同予以分组:对照组(n=30)采取传统解剖定位方式进行肌间沟臂丛神经阻滞麻醉,而研究组(n=30)采取超声引导定位方式进行麻醉,就2组患者的麻醉相关时间、麻醉阻滞效果以及围手术期间并发症发生率进行统计学分析。结果①研究组患者感觉阻滞起效时间、运动阻滞起效时间、麻醉起效时间均短于对照组(t=3.376、5.385、9.451,P<0.05);②研究组患者麻醉阻滞优良率93.33%高于对照组的70.00%(χ~2=5.455,P=0.020);③对照组并发症发生率是3.33%,与研究组的0.00%相比差异无统计学意义(χ~2=1.017,P=0.313)。结论超声引导定位行臂丛神经阻滞的麻醉效果确切,起效快,并能减少患者围术期并发症,值得借鉴。
Objective To investigate the anesthetic effect of ultrasound-guided localization of interscalene brachial plexus block. Methods A total of 60 patients with brachial plexus block treated in our hospital from January 2015 to June 2018 were selected and divided into two groups according to their location. The control group(n=30) was anesthetized by traditional anatomical location, while the research group(n=30) was anesthetized by ultrasound-guided location. And the anesthesia related time, anesthesia blocking effect and perioperative complications of the two groups were statistically analyzed. Results The onset time of sensory block, motor block and anesthesia in the study group were shorter than those in the control group(t=3.376, 5.385, 9.451, P=0.000). The excellent and good rate of anesthesia in the study group was 93.33%, which was higher than that in the control group(χ~2=5.455, P=0.020). And the incidence of complications in the control group was 3.33%, which was not statistically significant different from that in the study group(P<0.05)(χ~2=1.017, P=0.313). Conclusion Ultrasound-guided brachial plexus block has definite anesthetic effect, quick onset, and can reduce perioperative complications, which is worth learning.
Objective To investigate the anesthetic effect of ultrasound-guided localization of interscalene brachial plexus block. Methods A total of 60 patients with brachial plexus block treated in our hospital from January 2015 to June 2018 were selected and divided into two groups according to their location. The control group(n=30) was anesthetized by traditional anatomical location, while the research group(n=30) was anesthetized by ultrasound-guided location. And the anesthesia related time, anesthesia blocking effect and perioperative complications of the two groups were statistically analyzed. Results The onset time of sensory block, motor block and anesthesia in the study group were shorter than those in the control group(t=3.376, 5.385, 9.451, P=0.000). The excellent and good rate of anesthesia in the study group was 93.33%, which was higher than that in the control group(χ~2=5.455, P=0.020). And the incidence of complications in the control group was 3.33%, which was not statistically significant different from that in the study group(P<0.05)(χ~2=1.017, P=0.313). Conclusion Ultrasound-guided brachial plexus block has definite anesthetic effect, quick onset, and can reduce perioperative complications, which is worth learning.
引文
[1]刘涌.超声引导定位行臂丛神经阻滞麻醉与传统解剖定位行臂丛神经阻滞麻醉对上肢手术患者麻醉效果的比较研究[J].山西医药杂志,2017,46(6):694-696.
[2]熊显良,黄咏梅,陈东,等.超声引导肌间沟径路与锁骨上径路臂丛神经阻滞的麻醉效果比较[J].实用医院临床杂志,2016,13(2):105-107.
[3]许天华,艾菊.超声引导下锁骨上臂丛神经阻滞在重症老年患者上肢骨折手术麻醉中的应用体会[J].临床超声医学杂志,2016,18(12):835-838.
[4]Abdallah FW,Dwyer T,Chan VW,et al.IV and Perineural Dexmedetomidine Similarly Prolong the Duration of Analgesia after Interscalene Brachial Plexus Block:ARandomized,Three-arm,Triple-masked,Placebo-controlled Trial[J].Anesthesiology,2016,124(3):683.
[5]王伟华,王沫丽,孙俊.超声引导下与神经刺激器联合超声引导下腋路臂丛神经阻滞在下肘部位手术患者麻醉中应用比较[J].医学临床研究,2017,34(1):61-63.
[6]丁庆民,张海清.超声引导下相等低剂量不同浓度罗哌卡因用于臂丛神经阻滞的临床效果观察[J].河北医科大学学报,2016,37(12):1437-1440.
[7]刘玉,陈海涛,刘绍正,等.右美托咪定或地塞米松复合0.375%左旋布比卡因对超声引导下臂丛神经阻滞的影响[J].中国现代医学杂志,2016,26(21):117-120.
[8]鲍秀霞,黄娟娟,丰浩荣,等.相同浓度不同容量罗哌卡因超声引导锁骨上臂丛神经阻滞对膈肌麻痹的影响[J]临床麻醉学杂志,2017,33(8):768-771.
[9]赵玲,李静,党旭云,等.超声引导下C5和颈浅丛联合阻滞与高位臂丛神经阻滞在锁骨手术中应用效果的随机对照研究[J].第三军医大学学报,2018,40(3):242-247.
[10]张春元.超声引导和传统解剖定位法用于肌间沟臂丛神经阻滞的麻醉效果比较[J].福建医药杂志,2016,38(2):127-128.
[2]熊显良,黄咏梅,陈东,等.超声引导肌间沟径路与锁骨上径路臂丛神经阻滞的麻醉效果比较[J].实用医院临床杂志,2016,13(2):105-107.
[3]许天华,艾菊.超声引导下锁骨上臂丛神经阻滞在重症老年患者上肢骨折手术麻醉中的应用体会[J].临床超声医学杂志,2016,18(12):835-838.
[4]Abdallah FW,Dwyer T,Chan VW,et al.IV and Perineural Dexmedetomidine Similarly Prolong the Duration of Analgesia after Interscalene Brachial Plexus Block:ARandomized,Three-arm,Triple-masked,Placebo-controlled Trial[J].Anesthesiology,2016,124(3):683.
[5]王伟华,王沫丽,孙俊.超声引导下与神经刺激器联合超声引导下腋路臂丛神经阻滞在下肘部位手术患者麻醉中应用比较[J].医学临床研究,2017,34(1):61-63.
[6]丁庆民,张海清.超声引导下相等低剂量不同浓度罗哌卡因用于臂丛神经阻滞的临床效果观察[J].河北医科大学学报,2016,37(12):1437-1440.
[7]刘玉,陈海涛,刘绍正,等.右美托咪定或地塞米松复合0.375%左旋布比卡因对超声引导下臂丛神经阻滞的影响[J].中国现代医学杂志,2016,26(21):117-120.
[8]鲍秀霞,黄娟娟,丰浩荣,等.相同浓度不同容量罗哌卡因超声引导锁骨上臂丛神经阻滞对膈肌麻痹的影响[J]临床麻醉学杂志,2017,33(8):768-771.
[9]赵玲,李静,党旭云,等.超声引导下C5和颈浅丛联合阻滞与高位臂丛神经阻滞在锁骨手术中应用效果的随机对照研究[J].第三军医大学学报,2018,40(3):242-247.
[10]张春元.超声引导和传统解剖定位法用于肌间沟臂丛神经阻滞的麻醉效果比较[J].福建医药杂志,2016,38(2):127-128.