神经刺激仪定位改良腋路-肌间沟联合臂丛神经阻滞的临床应用

Clinical Use of Modified Axillary Interscalene and Brachial Plexus Block with Nerve Stimulator

目的探讨应用神经刺激仪辅助定位实行改良腋路-肌间沟联合臂丛神经阻滞麻醉的临床应用效果。方法 240例行上肢手术患者随机分成三组,每组各80例,均应用神经刺激仪辅助定位:组Ⅰ行肌间沟臂丛神经阻滞;组Ⅱ行腋路多点臂丛神经阻滞;组Ⅲ行改良腋路-肌间沟联合臂丛神经阻滞。观察各组臂丛神经阻滞成功率及不良反应。结果运用神经刺激仪行联合臂丛神经阻滞组优良率达100%,分别与组Ⅰ和组Ⅱ对比有显著性差异(P<0.05)。结论运用神经刺激仪行改良腋路-肌间沟联合神经阻滞可提高臂丛神经阻滞麻醉的质量与效果,同时减少了不良反应,是一种安全有效的好方法。

Objective To study the clinical effects of modified axillary interscalene and brachial plexus block guided by nerve stimulator.Methods 240（ASA Ⅰ～Ⅱ） cases undergoing upper limb surgery were randomly divided into three groups guided by nerve-stimulator.Group Ⅰ（n=80） and Group Ⅱ（n=80） were treated with interscalene brachial plexus block and axillary brachial plexus block respectively,while Group Ⅲ（n=80） was treated with axillary interscalene（AXIS） and brachial plexus block.Results There were significant differences in clinical effects between Group Ⅲ and the other two groups（P〈0.05）.Conclusion These results indicate that it is effective and safe to adopt modified axillary interscalene and brachial plexus block guided by nerve stimulator.