两种神经阻滞麻醉方式在锁骨骨折内固定术效果比较

Comparative study on effects of two different nerve block anesthesia in clavicle fracture fixation

目的探讨两种不同的神经阻滞麻醉在锁骨骨折内固定术中的麻醉效果。方法将52例行锁骨骨折内固定术的患者随机分为两组，每组26例。A组颈丛深浅支联合神经阻滞，B组单纯肌间沟臂丛神经阻滞。观察两组患者在麻醉前、切皮及骨折复位时的心电图（ECG）、非侵入性血压（NIBP）、心率（HR）、血氧饱和度（SpO2）和麻醉效果。结果两组患者3个时间点的NIBP、HR比较，差异均有显著性（P〈0．05）；A组的麻醉效果明显好于B组。结论颈丛深浅支联合神经阻滞是锁骨骨折内固定术中较好、可行的一种麻醉方法。

Objective To investigate the effect of the two different nerve block anesthesia on clavicle fracture fixation. Methods 52 cases of clavicular fracture fixation were randomly divided into two groups （n = 26） cervical plexus nerve block group （group A）, Brachial plexus block group （group B）. Non-invasive blood pressure （NIBP）, heart rate （H R）, oxygen saturation （SpO2） and electrocardiogram （ECG） were observed before anesthesia, incision, and fractures. We analyzed the anesthetic effect in different points time. Results （1）Compared with the group B, three time points NIBP and HR of group A were statistically significant（P 〈 0.05）, but there was no significant difference in the SpO2 between group A and group B （P〉 0.05）.（2）Compared with the group B,the anesthetic effect was statistically significant in group A（P 〈 0.05）. Conclusion The depth and superficial cervical plexus nerve block is a better and feasible anesthetic method in clavicle fracture fixation.