指压技术对臂丛神经下干阻滞效果的影响

Effect of digital pressure for inferior trunk brachial plexus block

目的探讨指压技术对臂丛神经下干(尺神经)阻滞效果及并发症发生率的影响。方法选择80例拟行上肢手术的患者,随机分为指压组(A组)和对照组(B组),分别给予0.4%罗哌卡因20ml行肌间沟臂丛神经阻滞术,A组接受指压技术,B组为对照组。观察并记录注药后1、2、5、15min的尺神经、正中神经、桡神经支配区域感觉阻滞起效、完善时间,阻滞完善成功率和并发症的情况。结果 (1)A组对尺神经的阻滞起效时间、完善时间及阻滞完善成功率均优于对照组;(2)A组临床麻醉效果优良率显著提高;(3)麻醉并发症发生率:A组低于B组。结论指压技术应用于肌间沟臂丛神经阻滞有助于局麻药向下干扩散,从而提高尺神经阻滞成功率,降低并发症,适于在基层医院推广。

Objective To explore the effect of digital pressure for inferior trunk（ulnar nerve） brachial plexus block and complication rates. Methods 80 patients scheduled for undergoing upper limb surgery under interscalene brachial plexus block（0.4% ropivacaine, 20ml） were included. They were randomly allocated into two groups： Group A（n=40）, receive digital pressure; Group B（n=40）, control group. The following measurements were made immediately at 1, 2, 5, 15 min after interscalene block injection： the onset and complete time of sensory blockade of ulnar nerve, medial nerve and radial nerve; satisfaction degree of nerve block and complications were observed and recorded. Results 1.The onset and complete time of ulnar nerve sensory block was significantly faster in the group A compared with the Group B, Group A showed higher degree of satisfaction of the ulnar nerve block than Group B. 2. Compared with controls, A group showed higher anesthesia satisfaction rate. 4. The Anesthesia complications incidence rate, Group A is better than B. Conclusions Digital pressure is an effective method to enhance the quality of blockade of the inferior trunk during interscalene brachial plexus block, improve the success rate of ulnar nerve block, reduce the complications, and is suitable for generalization in primary hospital.