胸锁乳突肌后缘入路星状神经节阻滞的临床应用

Application of satellite ganglion block via posterior edge of sternocleidomastoid approach

目的观察胸锁乳突肌后缘入路(SPA)星状神经节阻滞(SGB)效果。方法2400例拟接受SGB患者随机均分为两组。SPA组采用SPA法,传统气管旁入路(TPA)组采用TPA法,以相同药物浓度行SGB,比较两组成功率及相关并发症。结果SPA组1164例出现霍纳综合征(成功率97%),多于TPA组的1108例(成功率92%)(P<0.05)。SPA组发生因回血需要再次穿刺及喉返神经阻滞的例数明显少于TPA组(16例vs.98例,24例vs.37例)(P<0.05)。结论SPA法SGB较传统方法具有定位明确、操作简练、成功率高、并发症少等特点。

Objective To observe the outcomes of satellite ganglion block（SGB） via posterior edge of sternocleidomastoid approach. Methods SGB was performed in 2 400 patients, who were randomly divided into two groups with 1 200 cases each, The puncture of SGB in group SPA was via posterior edge of sternocleidomastoid approach and that in group TPA via traditional paratracheal approach. The same local anesthetics was used in two groups. The success rate （Homer＇s syndrome appearance） and complications were compared. Results The success rate was higher in group SPA than that in group TPA（97% vs. 92%） （P〈0.05）. Repeated puncture was needed in 16 cases in group SPA, which were less than 98 cases in group TPA（P〈0.05）. Laryngeal nerve block was occurred in 24 cases in group SPA, which were less than 37 cases in group TPA （P〈0.05）. Conclusion Compared to the traditional paratracheal approach, SGB via posterior edge of sternocleidomastoid approach has the advantages of clear positioning, easy puncture, higher success rate and less complications.