经腋路臂丛神经阻滞时手臂摆放位置对阻滞起效及持续时间的影响

背景评估经腋路臂丛神经阻滞（axinary block，AXB）后，不同手臂摆放位置对阻滞成功率、阻滞起效时间和持续时间的影响。方法实施AXB后，患者被随机分为2组：内收组患者迅速将手臂内收放置在身体两侧，外展组患者手臂依然保持阻滞时的外展姿势。这2组患者分别保持相应姿势到阻滞成功为止。结果外展组患者感觉神经及运动神经的阻滞起效时间显著短于内收组患者，外展组患者AXB的持续时间亦显著长于内收组患者（P〈0．001）。结论实施AXB后保持手臂外展体位，可以使感觉神经和运动神经的阻滞起效更快，阻滞持续时间更长。

BACKGROUND： We assessed the effects of arm position after block performance on success rate, onset time, and duration of axillary block （AXB）. METHODS： After performing AXB, patients were randomized into two groups： group adduction in which the arm was inmaediately placed in adduction along the body and group abduction in which the arm remained in abduction. These positions were maintained until the block was achieved. RESULTS： The sensory and motor blocks onset time were significantly shorter in the abduction group compared with that in the adduction group and their duration was significantly prolonged （P 〈 0.001 ）. CONCLUSIONS： Maintaining the arm in abduction after performing AXB allows a shorter onset time and a prolongation of the sensory and motor blocks.