超声引导臂丛神经阻滞在肥胖患者上肢手术中的应用效果

Application of ultrasound-guided brachial plexus block in upper limb surgery for obese patients

目的探讨超声引导臂丛神经阻滞在肥胖患者上肢手术中的应用效果。方法选择2016年1月~2017年6月期间收治的82例肥胖上肢手术患者为研究对象,根据随机数字表法分为两组,每组41例,对照组采用"体表异感法"进行肌间沟臂丛神经阻滞,观察组采用超声引导下肌间沟臂丛神经阻滞,比较两组麻醉效果及并发症发生率。结果观察组麻醉阻滞起效时间包括桡神经、尺神经和正中神经分别为(5.2±2.5)min、(7.6±3.8)min、(5.9±2.4)min,均明显短于对照组的(13.8±5.1)min、(20.3±7.2)min、(15.4±5.9)min,差异有统计学意义(P<0.05);观察组操作完成时间为(10.8±3.5)min,明显短于对照组的(13.8±5.1)min,差异有统计学意义(P<0.05);观察组麻醉效果优良率(100.00%)明显高于对照组(80.49%),并发症发生率(4.88%)明显低于对照组(29.27%),差异有统计学意义(P<0.05)。结论超声引导臂丛神经阻滞在肥胖患者上肢手术中具有阻滞起效快及阻滞完全等优点,并且可以降低并发症发生风险。

Objective To explore the effect of ultrasound-guided brachial plexus block in upper limb surgery for obese patients. Methods Eighty-two cases of obese patients with upper limb operation from January 2016 to June 2017 were selected as the research object, and they were divided into two groups according to randomly number method, with 41 cases in each group. The control group was given the ＂body surface feeling method＂ for intermuscular groove brachial plexus block, the observation group was given ultrasound guided interscalene brachial plexus block. The effect of anesthesia and the incidence of complications in the two groups were compared. Results The onset time of anesthesia block in the observation group, including the radial nerve, ulnar nerve and median nerve, were（5.2 ± 2.5） min,（7.6 ± 3.8） min, and（5.9 ± 2.4） min respectively, which were shorter than（13.8±5.1）min,（20.3±7.2）min,（15.4±5.9）min in the control group, the difference was statistically significant（P 0.05）. The operation time of the observation group was（10.8 ± 3.5） min, significantly shorter than（13.8 ± 5.1） min of the control group, and the difference was statistically significant（P 0.05）. The excellent rate of anesthetic effect in the observation group（100%） was significantly higher than that of the control group（80.49%）, and the incidence of complications（4.88%） was significantly lower than that of the control group（29.27%）, and the difference was statistically significant（P 0.05）. Conclusion Ultrasound guided brachial plexus block has the advantages of fast block onset and complete block in the upper limb operation of obese patients, and can reduce the risk of complications.