斜角肌间沟锁骨上入路臂丛阻滞对通气功能的影响

Interscalene and superclavical brachial plexus blocks affect respiratory function

目的：观察两种麻醉方法对患者呼吸功能的影响。方法：用日本产ＭＩＣＲＯＳＰＩＲＯ－２９８型呼吸功能仪检测了１０例肌间沟入路和８例锁骨上入路臂丛神经阻滞患者麻醉前后的通气功能。结果：发现患者肺活量（ＶＣ）、用力肺活量（ＦＶＣ）、１秒钟时间肺活量（ＦＥＶ１）均有显著下降（Ｐ＜０．０５），其下降幅度与既往报道由于单侧膈肌麻痹所造成的通气降低幅度相近。结论：作者认为此两种麻醉方法均可阻滞膈神经而导致单侧膈肌麻痹，引起通气功能降低，故此提出：（１）并发心肺疾患、呼吸代偿能力低下或有严重胸部损伤、呼吸功能不全者，慎行此两种神经阻滞；（２）不宜同时进行对侧锁骨上和肌间沟阻滞；（３）麻醉中慎用强力镇静药，以避免进一步加重呼吸抑制。

Objective:To detect the effects of interscalene and superclavical brachial plexus block on respiratory function Methods:The respiratory function of ten patients anesthesized with interscalene brachial plexus block and that of eight patients with superclavical brachial plexus block were tested Results:The vital capacity (VC),forced vital capacity (FVC) and force expiratory volume (FEV) were reduced significantly (P<0 05) following anesthesia Conclusion:Interscalene and superclavical brachial plexus blocks are safe to the normal patients but are dangerous to those suffering from serious lung and chest diseases