超声引导下肌间沟入路臂丛神经阻滞麻醉的应用及效果观察

Ultrasound-Guided Intermuscular Sulcus Approach for Brachial Plexus Block Anesthesia

目的探讨超声引导下肌间沟入路臂丛神经阻滞麻醉的应用及效果。方法选择2017年11月至2018年11月于我院行上肢手术患者80例,根据随机数字表法分为观察组和对照组,各40例。观察组采取超声引导下肌间沟入路臂丛神经阻滞,对照组使用传统解剖定位肌间沟入路臂丛神经阻滞,观察比较两组患者阻滞起效时间、阻滞持续时间,阻滞前后的心率、平均动脉压和麻醉效果。结果观察组的阻滞起效时间、阻滞持续时间均显著少于对照组(P<0.05);阻滞15 min后,两组的HR、MAP均显著高于阻滞前(P<0.05);两组患者的优良率存在统计学差异(P<0.05)。结论超声引导肌间沟路入臂丛神经阻滞麻醉,起效时间迅速,且能维持较长的神经阻滞效果,有效提高麻醉优良率,值得临床推广。

Objective To observe and discuss the application and effect of brachial plexus block anesthesia via intermuscular sulcus approach guided by ultrasound,and to summarize the clinical application value.Methods From November 2017 to November 2018,80 patients who underwent upper limb surgery in our hospital were divided into observation group and control group according to random number table extraction method,40 cases in each group.Ultrasound-guided brachial plexus block via intermuscular sulcus approach was used in the observation group,while traditional anatomy was used in the control group to locate the brachial plexus block via intermuscular sulcus approach.The onset time,duration of block,heart rate,mean arterial pressure and anesthetic effect before and after block were observed and compared between the two groups.Results The onset time and duration of blockade in the observation group were significantly less than those in the control group(P<0.05);HR and MAP in the two groups were significantly higher after 15 minutes of blockade than those before blockade(P<0.05);the excellent and good rates of the two groups were significantly different(X=4.51 correction,P<0.05).Conclusion Ultrasound-guided intermuscular sulcus approach for brachial plexus block anesthesia has a rapid onset time,and can maintain a long nerve block effect,effectively improve the excellent rate of anesthesia,which is worthy of clinical promotion.