超声引导下臂丛神经阻滞在上肢手术中的临床观察和经验

Clinical application of brachial plexus block by ultrasound-guided in limb surgery

目的研究超声引导臂丛神经阻滞相对于传统盲探下臂丛神经阻滞的优越性和实践经验。方法选取我院采用超声引导臂丛神经阻滞上肢手术20例(超声引导组),同时选择同期采用盲探异感法臂丛神经阻滞(盲探臂丛阻滞组)20例,比较两组患者各生理指标、生命体征变化、神经阻滞效应和并发症。结果超声引导组患者的麻醉起效时间、镇痛维持时间、成功率均优于盲探臂丛阻滞组,两组比较差异有统计学意义(P<0.05);盲探臂丛阻滞组的并发症高于超声引导组,但其差异没有统计学意义(P>0.05)。结论超声引导下臂丛神经阻滞有助于使麻药准确注入至最佳位置,提高麻醉质量。

Objective To observe the safety and superiority of ultrasound-guided interscalene brachi-al plexus blockade in limb surgery and summarize experience.Methods Eighty patients with limb sur-gery were included in this study.Of them,20 cases underwent surgical procedure by ultrasound-guided interscalene brachial plexus blockade way,while another 20 were treated with an anesthetic method by blind approach to brachial plexus block.The vital signs,effects of nerve block,complications between two groups were recorded and compared.Results The time of anesthesia initiation,the duration of anal-gesia and the success rate of the patients in the ultrasound-guided group were all superior to those of the blind brachial plexus block group,and the difference between the two groups was statistically significant(P<0.05).The number of complications in blind approach-brachial plexus block group was higher than that in the ultrasound guided group,but the difference was not statistically significant(P>0.05).There was no significant difference in the MA P,HR and RR between the two groups(P>0.05).Conclusion Ultrasound-guided brachial plexus block can help to the anesthetic to the accurate position and improve the quality of anesthesia.