肌间沟臂丛神经阻滞行B超定位的临床效果观察

CLINCAL EFFECT OF THE TRENCH BETWEEN MUSCLE BRACHIAL PLEXUS BLOCK IMPLEMENTATION BY ULTRASOUND LOCALIZATION

目的 探讨肌间沟臂丛神经阻滞实施B超定位的临床效果。方法 将120名ASAⅠ-Ⅱ级上肢手术患者进行随机分组,分为Ⅰ、Ⅱ、Ⅲ三组每组40例,其中Ⅰ组采用B超定位肌沟臂丛神经阻滞,Ⅱ组实施神经刺激器进行定位,Ⅲ组采用传统异感进行定位,药物为1%利多卡因＋0.5%罗哌卡因20ml。结果Ⅰ组对正中神经以及尺神经阻滞有效的人数明显高于Ⅱ和Ⅲ组,差异有统计学意义（P〈0.05）。Ⅰ组的麻醉起效时间、痛觉消失时间和Ⅱ组对比,差异无统计学意义（P〉0.05）,与Ⅲ组比较差异有统计学意义（P〈0.05）;Ⅰ组的镇痛维持时间比Ⅲ组长（P〈0.05）,但是阻滞的有效例数比较多,和Ⅱ组比较差异有统计学意义（P〈0.05）,Ⅰ组发生刺入血管失误率同Ⅱ和Ⅲ组比较明显较低（P〈0.05）。结论 B超定位肌间沟臂丛神经阻滞的起效比较快,阻滞比较完善,成功率比较高,并且并发症出现的比较少,是一种安全性和可靠性比较高的新技术,具有重要的推广价值。

Objective To explore the trench between muscle brachial plexus block implementation of the clinical effect of ultrasound localization. Methods A total of 120 ASA I -class II upper extremity surgery patients were randomized, divided into three groups, 40 cases in each group, the group I used ultrasound positioning groove brachial plexus block, group II implemented of nerve stimulator to locate, group III used the traditional sense of vision to locate, All patients accepted a local anesthesia; drugs included 1% Lidocaine and 0.5% Ropivacaine. Results The group I of median nerve and ulnar nerve block effective number was significantly higher than that of group II and III , and data uncter the differences （P〈0.05}. Anesthesia group I work time, pain hours time and contrast group II , was no obvious difference, （P〉0. 05）, and group III was statistically significant （P〈0.05）, the effect of group I keep for a long time, compared with group III （P〈0.05, but the block of valid cases was more, compared with group 11 （P〈0. 05, the group I Pierce vessels errors compared with group II and III significantly lower （P〈0.05）. Conclusions B ultrasonic positioning groove of the brachial plexus block between muscle work is faster. Block is more perfect, the success rate is higher, and less complications, is a kind of safety and reliability, high new technology, has the important value of promotion.