超声引导下腋路连续臂丛阻滞应用于手外伤患者术后镇痛疗效

Effect of Ultrasound-guided Axillary Continuous Brachial Plexus Block on Postoperative Analgesia in Patients with Hand Injury

目的探析超声引导下腋路连续臂丛阻滞在手外伤患者术后镇痛中应用的效果。方法选取2016年12月至2017年8月东莞市黄江医院行断指再植手术的手外伤患者中选出60例,随机分成两组,对照组患者术后按需予以肌肉注射曲马多针100 mg镇痛,研究组患者于术后即刻在超声引导下行腋路连续神经阻滞镇痛,对比两组的VAS评分等。结果术后18、24、48、72 h,研究组的VAS疼痛评分均低于对照组,P<0.05;术后镇痛相关并发症发生率上,研究组的6.67%明显低于对照组的30.0%,P<0.05。结论超声引导下的腋路连续臂丛阻滞具有定位精确、神经阻滞完全、无误伤神经血管风险等优点,在断指再植的手外伤患者术后镇痛中应用有助于确保患者术后的无痛功能锻炼顺利进行,提高患者术后舒适度。

Abstract： Objective To explore of the effect Ultrasound-guided axillary continuous brachial plexus block on postoperative anal- gesia in patients with hand injury. Methods 60 cases of patients with hand injury, treated by finger replantation surgery in Huang3iang Hospital of Dongguan city from December 2016 to August 2017, were selected and randomly divided into two groups. The control group was given intramuscular injection of 100mg tramadol for postoperative analgesia as required, while the experiment group underwent the ultrasound-guided axillary continuous nerve block for analgesia immediately after the operation. The VAS scores of the two groups were compared. Results VAS pain scores of the experiment group 18h, 24h, 48h, and 72h after the operation were low- er than those of the control group （P〈0. 05 ） ; the incidence rate of complications related with postoperative analgesia of the experiment group was 6. 67%, which was significantly lower than that of the control group （30%） （P〈0.05）. Conclusion Ultrasound-guided axillary continuous brachial plexus block has the advantages of accurate positioning, complete nerve block, and no injury to nerve and blood vessels, etc. Its application in postoperative analgesia in patients with hand injury after finger replantation helps to ensure that the painless functional exercise after operation can be carried out smoothly, and improve the patient＇s postoperative comfort level.