超声引导定位与传统解剖定位行臂丛神经阻滞的麻醉效果对比分析

Analysis of Comparison of Anesthesia Effect of Ultrasound Guided Orientation and Traditional Anatomic Orientation for Brachial Plexus Block

目的对比分析超声引导定位与传统解剖定位行臂丛神经阻滞的麻醉效果。方法随机抽取于2016年1—12月时间段内笔者所在医院收治的拟行上肢手术的患者80例,以国际随机数字表法分为观察组和对照组,各40例患者。超声组患者在超声引导定位下行臂丛神经阻滞麻醉,传统组患者行传统解剖定位臂丛神经阻滞麻醉。结果超声组患者的麻醉完成时间、起效时间分别为(3.1±2.0)、(3.4±2.3)min,明显比传统组患者的(5.7±1.3)、(4.8+3.1)min短,差异有统计学意义(P<0.05);超声组患者的阻滞效果评分(2.7±0.4)分,明显比传统组患者的(3.6±0.5)分好,差异有统计学意义(P<0.05)。超声组患者的臂丛神经阻滞麻醉效果I级40例,明显比传统组患者的27例多,差异有统计学意义(P<0.05)。超声组患者术后1、4、24 h时的NRS评分分别为(1.1±0.9)分、(1.3±0.8)分、(2.0±1.5)分,均明显比传统组患者的(3.1±1.8)分、(3.8±1.9)分、(4.1±2.0)分低,差异有统计学意义(P<0.05)。超声组患者麻醉并发症及不良反应发生率为20.0%,明显比传统组患者的5.0%低,差异有统计学意义(P<0.05)。结论与传统解剖定位臂丛神经阻滞麻醉相比,超声引导定位臂丛神经阻滞麻醉具有定位简单,直观性强,可在麻醉实施过程中有效避开患者的血管、周围重要组织结构等优势,从而提高臂丛神经阻滞麻醉的安全性和成功率,促使臂丛神经阻滞麻醉效果得到显著提升,降低患者术后各时间点的疼痛程度,减少麻醉不良反应及并发症,具有极高的临床应用价值,可在临床上进行大力推广。

Objective To compare and analyze the anesthesia effect of ultrasound guided orientation and traditional Anatomic orientation for brachial plexus block. Methods 80 cases of patients with upper limb surgery admitted and treated in our hospital from January to December 2016 were selected and randomly divided into two groups with 40 cases in each,the ultrasound group and the traditional group were respectively treated with ultrasound guided orientation and traditional anatomic orientation. Results The anesthesia completion time and onset time in the ultrasound group were obviously shorter than those in the traditional group[（3.1±2.0）,（3.4±2.3）min vs（5.7±1.3）,（4.8±3.1）min]（P〈0.05）, and the blocking effect in the ultrasound group was obviously better than that in the traditional group, [（2.7±0.4）points vs（3.6±0.5）points], and the difference was statlistlicay significant（P〈0.05）, and the anesthesia effect I level of brachial plexus block in the ultrasound group was obviously more than that in the traditional group（ 40 cases vs 27 cases）（P〈0.05）, and the NRS scores at 1, 4, 24 h after surgery in the ultrasound group were obviously lower than those in the traditional group [（1.1±0.9）points,（1.3±0.8）points,（2.0±1.5）points vs（3.1±1.8）points,（3.8±1.9）points,（4.1±2.0）points], and the differences were statlistlicay significant（P〈0.05）, and the incidence rate of anesthesia complications and adverse reactions was obviously lower than that in the traditional group（20.0% vs 5.0%）, and the difference was statlistlicay significant（P〈0.05）. Conclusion The anesthesia of ultrasound guided orientation for brachial plexus block has the advantages of simple orientation and strong intuition compared with the traditional anatomic orientation, which can effectively avoid the blood vessels and important soft tissue structure thus improving the anesthesia safety and success rate of brachial plexus block, promote the obvious improvement of anesthesia effect of ultrasound guided orientation, reduce the pain degrees at various time points after surgery and reduce the anesthesia adverse reactions and complications with extremely high clinical application value, and it can be greatly promoted in clinic.