彩超引导下臂丛神经阻滞与盲法穿刺对手术患者麻醉效果对比及对炎症因子水平的影响

Contrast of anesthetic effect between color Doppler ultrasound-guided brachial plexus block and blind puncture on surgical patients and its effect on inflammatory factors

目的:观察彩超引导下臂丛神经阻滞与盲法穿刺对手术患者麻醉效果对比及对炎症因子水平的影响。方法:纳入2017年4月~2018年4月在我院行上肢手术的120例患者,随机分为观察组(n=60)和对照组(n=60),对照组实施盲法穿刺肌间沟联合腋路臂丛神经阻滞,观察组行彩超引导下的肌间沟联合腋路臂丛神经阻滞。观察两组患者麻醉效果,对比麻醉用时、药物用量,观察两组血清IL-6和TNF-α水平,统计感染等不良反应发生情况。结果:观察组患者麻醉成功率为98.33%,显著高于对照组的86.67%,差异具有统计学意义;观察组麻醉操作时间、起效时间均短于对照组,局麻药用量少于对照组,差异均具有统计学意义;观察组术后血清IL-6和TNF-α水平均低于对照组,差异具有统计学意义;观察组感染、呼吸困难以及Horner综合征发生率分别为3.33%、1.67%和0%,显著低于对照组的13.33%、11.67%和3.33%,差异均具有统计学意义。结论:彩超引导下的臂丛神经阻滞能够有效提高阻滞成功率,缩短操作时间,减少药物使用剂量,减轻机体炎症水平,提高臂丛阻滞的安全性。

Objective To observe the effect of color Doppler ultrasound-guided brachial plexus block and blind puncture on anesthesia and the level of inflammatory factors in surgical patients.Methods 120 patients who underwent upper limb surgery in our hospital from April 2017 to April 2018 were randomly divided into observation group(n=60)and control group(n=60).The control group was treated with blind puncture of intermuscular sulcus combined with axillary brachial plexus block.The observation group was treated with color Doppler ultrasound-guided intermuscular sulcus combined with axillary brachial plexus block.Observe the anesthesia effect of the two groups,compare the anesthesia time and drug dosage,observe the levels of IL-6 and TNF-alpha in serum of the two groups,and count the incidence of adverse reactions such as infection.Results The success rate of anesthesia in the observation group was 98.33%,higher than control group(86.67%);the operation time and onset time of anesthesia in the observation group were shorter than those in the control group,and the dosage of local anesthetics was less than that in the control group;the levels of serum IL-6 and TNF-alpha in the observation group were lower than those in the control group;The incidence of infection,dyspnea and Horner syndrome in the observation group was 3.33%,1.67%and 0%respectively,which was significantly lower than that in the control group(13.33%,11.67%and 3.33%,respectively),and the difference was statistically significant.Conclusion Brachial plexus block guided by color Doppler ultrasound can effectively improve the success rate of brachial plexus block,shorten the operation time,reduce the dosage of drugs,reduce the level of inflammation and improve the safety of brachial plexus block.