超声引导下行肌间沟臂丛神经麻醉在肥胖患者中的应用效果

Application efficacy of ultrasound-guided interscalene brachial plexus anesthesia on obese patients

目的探讨超声定位引导下肌间沟臂丛神经麻醉在肥胖患者中的应用效果。方法将66例择期施行上肢手术的肥胖(体重指数≥30 kg/m^2)患者分为观察组与对照组,每组33例。观察组应用超声引导定位行肌间沟臂丛神经麻醉,对照组应用神经刺激仪定位肌间沟臂丛神经麻醉,对比两组的麻醉效果。结果观察组的正中神经、尺神经、桡神经及肌皮神经的感觉阻滞起效时间均短于对照组(P<0.05),完全阻滞率均高于对照组(P<0.05);观察组的麻醉效果优良率为96.97%,显著高于对照组的66.67%(P<0.05);观察组并发症发生率为0,明显低于对照的15.15%(P<0.05)。结论对于肥胖患者,在超声定位引导下行肌间沟臂丛神经麻醉可提高阻滞的精确性与有效性,缩短阻滞起效时间,提高麻醉质量,减少并发症。

Objective To evaluate the application efficacy of ultrasound-guided interscalene brachial plexus anesthesia on obese patients. Methods A total of 66 obese patients （body mass index ≥ 30 kg/m2） undergoing selective surgeries on upper extremities were divided into observation group and control group, with 33 cases in each group. Observation group underwent ultrasound-guided interscalene brachial plexus anesthesia, and control group underwent nerve stimulator-located interscalene brachial plexus anesthesia. The efficacies of anesthesia were compared between two groups. Results Observation group achieved shorter onset times of sensory block in median nerve, ulnar nerve, radial nerve and muscle cutaneous nerve, and higher complete block rate of each nerve compared to control group （ P 〈 0.05 ）. The excellent rate of anesthetic efficacy of observation group was significantly higher than that of control group （96.97 % vs. 66.67 % , P 〈 0.05 ）. The incidence of complications in the observation group was significantly lower than that in the control group （0 vs. 15.15 %, P 〈 0.05 ）. Conclusion For obese patients, ultrasound-guided interscalene brachial plexus anesthesia can improve the accuracy and effectiveness of nerve block,shorten the onset time of sensory block,improve the quality of anesthesia and reduce the incidence of complications.