肌间沟法臂丛神经阻滞麻醉的临床效果观察

Clinical effect of brachial plexus block anesthesia via intermuscular groove

目的探讨肌间沟法臂丛神经阻滞麻醉的临床效果。方法 120例上肢手术患者,根据随机数字表法分为对照组和观察组,各60例。对照组采用肌间沟法臂丛上支神经阻滞麻醉,观察组采用肌间沟法臂丛中支神经阻滞麻醉。比较两组的治疗效果、麻醉前后血流动力水平、不良反应发生情况、痛觉阻滞发挥作用时间、阻滞完善时间、麻醉药物总剂量、麻醉维持时间。结果观察组总有效率为100.00%,高于对照组的75.00%,差异具有统计学意义(P<0.05)。麻醉前,两组平均动脉压、心率比较差异无统计学意义(P>0.05);麻醉后观察组血流动力水平优于对照组,差异具有统计学意义(P<0.05)。观察组患者不良反应发生率为1.67%,明显低于对照组的16.67%,差异具有统计学意义(P<0.05)。观察组痛觉阻滞发挥作用时间、阻滞完善时间、麻醉药物总剂量、麻醉维持时间均优于对照组,差异具有统计学意义(P<0.05)。结论肌间沟法臂丛中支神经阻滞麻醉在实施上肢手术麻醉中的效果确切,可更好的维持血流动力学指标稳定和减少不良反应发生,提升麻醉的效果,缩短痛觉阻滞发挥作用时间、阻滞完善时间,减少麻醉药物总剂量,延长麻醉维持时间。

Objective To discuss the clinical effect of intermuscular groove brachial plexus block anesthesia. Methods A total of 120 patients with upper limb surgery were divided by random number table method into control group and observation group, with 60 cases in each group. The control group received brachial plexus block anesthesia via superior intermuscular groove, and the observation group received brachial plexus block anesthesia via middle intermuscular groove. Comparison were made on treatment effect, hemodynamic level before and after anesthesia, occurrence of adverse reactions, time of pain blockade, time of block improvement, total dose of anesthetics and duration of anesthesia between the two groups. Results The observation group had higher total effective rate as 100.00% than 75.00% in the control group, and the difference was statistically significant(P<0.05). Before anesthesia, both groups had no statistically significant difference in mean arterial pressure and heart rate(P>0.05). After anesthesia, the observation group had better hemodynamic level than the control group, and the difference was statistically significant(P<0.05). The observation group had obviously lower incidence of adverse reactions as 1.67% than 16.67% in the control group, and the difference was statistically significant(P<0.05). The observation group had better time of pain blockade, time of block improvement, total dose of anesthetics and duration of anesthesia than the control group, and the difference was statistically significant(P<0.05). Conclusion Brachial plexus block anesthesia via middle intermuscular groove has a definite effect in upper limb surgery anesthesia. It can better maintain the stability of hemodynamic indicators, reduce adverse reactions, improve the anesthetic effect, shorten the time of pain block, block perfect time, reduce the total dose of anesthetics, and prolong the duration of anesthesia.