肌间沟臂丛麻醉简易快速定位方法的临床应用

Clinical application of simple and rapid positioning of interscalene brachial plexus

目的比较两种肌沟间臂丛麻醉定位方法的临床效果。方法 2014年2月至2015年9月筛选的80例上肢手术的患者,在一般资料无显著差异的情况下,分组采用两种不同的肌间沟定位方法(传统组和三指法组)做了臂丛麻醉,比较研究了其麻醉效果和并发症。结果三指法定位快速、麻醉效果为优者达85%,良者10%,差者5%,无一例并发症发生,成功率达95%。传统组麻醉效果为优者达75%,良者15%,差者10%,有2例并发症出现,成功率90%。麻醉起效时间三指法组优于传统组(P<0.05),麻醉维持时间三指法组优于传统组(P<0.05)结论三指法避免了将胸锁乳突肌锁骨支与前斜角肌,或中斜角肌与后斜角肌的间隙误认为肌间沟的弊端。定位简单快速,麻醉效果明显,并发症发生率低。值得临床推广应用。

Objective To compare the clinical effect of brachial plexus anesthesia positioning method between the two kinds of muscle. Methods In February 2014 to September 2015, 80 cases of patients were screened with upper limb sur- gery, and there was no significant difference in the general in- formation of the cases.The brachial plexus anesthesia was per- foemed between two different muscle groups in a single trench locating methods （traditional group and three fingering） to compare the narcotic effect and complications. Results Three fingering positioning is rapid, with the anesthetic effect for instituting of 85%, 10%, the person＇ s claim 5%. There were no complications and the effective rate is 95%. Traditional group anesthetic effect of instituting of 75%, 15%, the per- son＇ s claim 10%, 2 cases with complications, 90% effective rate. For the anesthesia effect time, three fingering is superior to the traditional group （P〈0.05） . For the maintain anesthe- sia time, three fingering is superior to the traditional group （P 〈0.05） . Conclusion Three fingering positioning will avoid the disadvantages of the sternocleidomastoid collarbone and former scalene muscle, or scalene gap after scalenus as the myenteric ditch. Simple rapid positioning, anesthesia effect is obvious, low complication rates. It is worth clinical popularizing.