颈浅丛联合颈椎横突阻滞在锁骨骨折手术中的应用

Superficial cervical plexus combined cervical transverse process block in the clavicular fracture surgery

目的比较颈浅丛联合肌间沟臂丛神经阻滞与颈浅丛联合C5或C6横突神经阻滞的效果,为锁骨骨折手术寻找一种简便有效的麻醉方法。方法选取锁骨骨折病人60例(内侧1/3骨折和外侧2/3骨折各30例),分为A、B两组:A组采用颈浅丛联合肌间沟臂丛神经阻滞,B组内侧1/3骨折采用颈浅丛联合C5横突神经阻滞,外侧2/3骨折采用颈浅丛联合C6横突神经阻滞。每组含内侧1/3骨折和外侧2/3骨折各15例。结果 A组成功率为60.0%,B组成功率为83.3%,B组成功率明显高于A组(P<0.05)。结论颈浅丛联合C5横突或C6横突是一种定位简单、安全有效的麻醉方法。

Objective To find a simple and effective way of anesthesia for clavicle fracture patients by com-parison the effect of superficial cervical plexus combined interscalene block with superficial cervical plexus combined the fifth cervical vertebra（C5） transverse process（for the medial 1/3 clavicle fracture） or the sixth cervical（C6） trans-verse process（for the lateral 2/3 clavicle fracture） block.Methods 30 medial 1/3 clavicle fracture patients and 30 lat-eral 2/3 clavicle fracture patients were randomly divided into group A and group B,which made 15 medial 1/3 of frac-tures patients and 15 lateral 2/3 clavicle fractures patients in each group.Group A were performed superficial cervical plexus combined with interscalene block,Group B were performed superficial cervical plexus combined with C5（for the medial 1/3 fracture） or C6（for lateral 2/3 fracture） transverse process block.Results Group A successful rate was 60%,and group B successful rate was 83.3%.The anesthesia effect was better in group B than that in group A.Con？ clusion The superficial cervical plexus combined C5（for the medial 1/3 fracture） or C6（for lateral 2/3 fracture） trans-verse process is a simple,safe and effective method for clavicle fracture patients.