超声联合神经刺激器引导对腋路臂丛神经阻滞效果的影响

Influence of ultrasound combined with nerve stimulator guidance on the effect of axillary brachial plexus block

目的比较超声联合神经刺激器引导与超声引导对腋路臂丛神经阻滞效果的影响。方法选择2018年1~4月拟在本院行前臂及手部手术的100例患者作为研究对象,采用随机数字表法将患者分为超声联合神经刺激器组(NU组)及对照组(U组),每组各50例。NU组患者采用超声联合神经刺激器引导,U组患者仅采用超声引导。观察两组患者的麻醉效果、神经阻滞起效时间、手术情况及并发症发生情况。结果NU组患者的神经阻滞麻醉成功率(100.00%)高于U组(72.00%),差异有统计学意义(P<0.05)。NU组患者的肌皮神经、桡神经、正中神经、尺神经感觉阻滞起效时间均短于U组,差异有统计学意义(P<0.05)。NU组患者的操作时间短于U组,神经阻滞持续时间长于U组,差异有统计学意义(P<0.05)。NU组患者的并发症总发生率(4.00%)低于U组(26.00%),差异有统计学意义(P<0.05)。结论超声联合神经刺激器引导腋路臂丛神经阻滞的成功率更高,起效时间及操作时间更短,持续时间更长,且并发症较少,表明超声联合神经刺激器引导腋路臂丛神经阻滞有效且安全。

Objective To compare the influence of ultrasound combined with nerve stimulator guidance and ultrasound guidance on the effect of axillary brachial plexus block.Methods A total of 100 patients who intended to undergo forearm and hand surgery in our hospital from January to April 2018 were selected as the research objects,and the patients were divided into ultrasound combined with nerve stimulator group(group NU)and control group(group U)by the random number table method,50 cases in each group.The group NU was guided by ultrasound combined with nerve stimulator,and the group U was only guided by ultrasound.The anesthesia effect,nerve block onset time,operation and incidence of complications between the two groups were observed.Results The success rate of nerve block anesthesia in the group NU(100.00%)was higher than that in group U(72.00%),the difference was statistically significant(P<0.05).The sensory block onset time of musculocutaneous nerve,radial nerve,median nerve and ulnar nerve in the group NU was shorter than that in the group U,and the difference was statistically significant(P<0.05).The operation time in the group NU was shorter than that in the group U,and the duration of nerve block was longer than that in the group U,with statistically significant differences(P<0.05).The total incidence of complications in the group NU(4.00%)was lower than that in the group U(26.00%),and the difference was statistically significant(P<0.05).Conclusion Ultrasound combined with nerve stimulator to guide axillary brachial plexus block has a higher success rate,shorter onset time,operation time,longer duration,and fewer complications,indicating that ultrasound combined with nerve stimulator to guide axillary brachial plexus block is effective and safe.