臂神经丛联合阻滞的应用

Application of combined brachial plexus block

目的总结"四针法"臂丛神经联合阻滞的经验,指导神经刺激仪的合理应用。方法回顾性分析臂神经丛阻滞356例,根据阻滞方法分为联合组(n=148),联合组同时实施肌间沟阻滞加腋路阻滞加肋间臂神经阻滞;传统组(n=208),传统组只实施肌间沟阻滞(n=176),或腋路阻滞(n=32),不行肋间臂神经阻滞。结果联合组麻醉效果优占97.3%,穿刺异感占47.3%;传统组优占87.0%,穿刺异感占69.7%。联合组与传统组比较,具有显著差异(P<0.01)。结论 "四针法"臂神经丛联合阻滞可提高臂神经丛阻滞的成功率。

Objective To summarize the experience of applying combined brachial plexus block with four point injection and to guide the proper use of nerve stimulator.Methods The clinical data of 356 patients treated with brachial plexus block were retrospectively analyzed.The patients in study group（n=148） were received combined brachial plexus block including interscalene block,axillary block and intercostobrachial nerve block simultaneously.The patients in control group（n=208） only received interscalene block（n=176） or axillary block（n=32）.Results Significant differences in anesthesia effect and puncture paresthesia were observed between the two groups.The excellent anesthesia effect in study group was 97.3% while that in control group was 87.0%.Puncture paresthesia was existed in 47.3% of study group and 69.7% of control group.Conclusion The success rate of brachial plexus block can be improved by employing combined brachial plexus block with four point injection.