上肢手术行肌间沟两点臂丛神经阻滞的临床观察

Clinical observation of two-point methods of nerve localization applied to upper extremity operations in interscalene brachial plexus block

目的比较肌问沟阻滞中常规一点方法与两点方法的临床效果。方法 60例行上肢手术患者,采用一点和两点行肌间沟阻滞,随机分为A、B组,每组30例。评估麻醉后感觉和运动的阻滞程度,手术过程中的阻滞效果(优、良、失败),并观察和记录并发症。结果前臂内侧皮神经的感觉、尺神经的感觉及运动B组好于A组(P<0.05),B组优良率为93.3%,A组优良率为83.3%,霍纳综合征B组高于A组(P<0.01)。结论上肢手术中两点肌间沟阻滞效果优于一点阻滞。

Objective To compare the clinical effects of the interscalene brachial plexus block performed by two-point or one-point methods of nerve localization. Methods 60 patients sched- uled for upper extremity operations were randomly grouped into A and B with 30 cases for each. The extent of sensory and motor blocked of each in innervated region and the anesthetic effect of surgical （rated as excellent, good and failure） were assessed and the complications were observed and recorded as well. Results The sensory scale scores of cutaneous antebrachii medialis nerve and cubital nerve and the motor scores of cubital nerve were significantly higher in group B than in group A （P 〈0.05）. The Horner＇s syndrome in group B was significantly higher than in group A （P 〈0.01）. The excellent rate of anesthetic effect surgical field was 93.3% in group B and 83.3% in group A. Conclusion The two-point methods of nerve localization in upper extremity operations is more effective than one-point.