超声引导下肌间沟臂丛神经阻滞的临床应用

Application of ultrasound-guided interscalene brachial plexus block

目的比较超声引导下肌间沟臂丛神经阻滞(ISBPB)与传统解剖定位ISBPB的临床效果。方法50例择期上肢手术的患者,随机均分为超声引导组(U组)和传统解剖定位组(C组),每组25例。U组在便携式二维超声仪的引导下多靶点注射0.375%罗哌卡因和1.0%利多卡因局麻药混合液20ml;C组采用传统ISBPB法注射相同量局麻药混合液。20min后评价各神经分布区的痛觉、麻醉效果和并发症的记录。结果U组的尺神经、正中神经、前臂内侧皮神经阻滞完善率明显高于C组(96%vs.80%,96%vs.76%,96%vs.72%)(P<0.05)。C组穿刺过程中有4例刺破血管。结论超声引导下ISBPB比传统的解剖定位下ISBPB阻滞效果好、安全性高、并发症少。

Objective To compare the outcome of interscalene brachial plexus block（ISBPB） guided by ultrasound with that of conventional technique. Methods Fifty patients scheduled for upper extremity operation under ISBPB were randomized into two groups of U（guided by ultrasound） and C （using conventional technique） with 25 cases each. The local anaesthetic solution consisted of 0. 375 ropivacaine and i. 0% lidocaine 20 mL The sensory blockade of the brachiai plexus was evaluated 20 rain after injection. The complication was recorded as well. Results The rate of complete blockade for the median, ulnar and medial antebrachial cutaneous nerves was higher in group U than that in group C （96% vs. 80%,96% vs. 76%,96% vs. 72%）（P〈0.05）. Inadvertent arterial puncture occurred in 4 cases in group C. Conclusion Ultrasound-guided ISBPB is significantly better than conventional ISBPB in obtaining complete blockade with less complication.