神经刺激仪定位与盲探法用于神经阻滞的麻醉效果比较

Comparison of the anesthesia effects of nerve stimulator localization and blind exploration method in nerve block

目的比较神经刺激仪定位神经阻滞与盲探法用于麻醉的临床应用效果。方法选择西双版纳傣族自治州人民医院2015年10月至2017年5月择期实施上肢手术的患者132例为研究对象,采用随机数字表法分为盲探穿刺神经阻滞组(B组,n=66例)和神经刺激仪定位神经阻滞组(N组,n=66例),观察两组患者的麻醉良好率和并发症发生情况。结果B组麻醉药物剂量(1%利多卡因与0.375%罗哌卡因混合液)为(17.6±4.1)mL,N组为(18.1±4.8)mL,两组差异无统计学意义(t=-0.66,P>0.05);N组麻醉良好率为79.0%,高于B组的53.0%,两组差异有统计学意义(χ^2=9.74,P<0.05);B组有5例患者因手术疼痛剧烈改全身麻醉(7.6%),N组无患者改麻醉方式,两组差异有统计学意义(χ^2=5.20,P<0.05);N组并发症发生率为1.5%,低于B组的6.1%,两组差异有统计学意义(χ^2=4.16,P<0.05)。结论神经刺激仪在神经阻滞麻醉中有较好的应用价值。

Objective To compare the clinical effects of neurostimulator positioning nerve block and blind exploration in anesthesia.Methods One hundred and thirty-two patients undergoing upper extremity surgery in the People's Hospital of Xishuangbanna Dai Nationality Autonomous Prefecture were enrolled in this study.According to the digital table,the patients were randomly divided into two groups: blind probing nerve block group(B group,n=66) and neurological stimulator locating nerve block group(N group,n=66). The good rate of anesthesia and complications of the two groups and so on were observed.Results The dosage of anesthetic in B group was (17.6±4.1)mL for anesthesia with 1% lidocaine and 0.375% ropivacaine,which in N group was (18.1±4.8)mL,there was no statistically significant difference between the two groups(t=-0.66,P>0.05). The good rate of anesthesia in N group was 79.0%,which was higher than that in B group(53.0%),the difference between the two groups was statistically significant(χ^2=9.74,P<0.05). There were 5 cases(7.6%) turned to general anesthesia because of severe pain in B group,there was no change of anesthesia in N group,the difference was statistically significant(χ^2=5.20,P<0.05). The incidence rate of complications in N group was 1.5%,which was lower than 6.1% in B group,the difference was statistically significant(χ^2=4.16,P<0.05).Conclusion Nerve stimulator has good application value in nerve block anesthesia as a good and cheap tool.