神经刺激仪联合超声在肥胖患者肌间沟臂丛麻醉中的应用效果分析

Application of nerve stimulator combined with ultrasound on interscalene brachial plexus anesthesia in obese patients

目的探讨神经刺激仪联合超声在肥胖患者肌间沟臂丛麻醉中的应用价值。方法选取在我院拟应用肌间沟臂丛麻醉的78例肥胖患者为研究对象,按照随机数字表法分为对照组和研究组,每组39例。对照组应用神经刺激仪辅助进行肌间沟臂丛麻醉,研究组应用神经刺激仪联合超声辅助进行肌间沟臂丛麻醉。比较2组患者的麻醉完成时间、麻醉起效时间、镇痛持续时间、臂丛神经痛觉阻滞完善率、麻醉有效率、并发症发生率及患者满意度。结果研究组患者麻醉完成及起效时间均短于对照组(P<0.05),镇痛持续时间长于对照组(P<0.05)。2组患者桡神经及肌皮神经阻滞完善率比较,差异无统计学意义(P>0.05);而研究组患者正中神经、尺神经及前臂内侧皮神经阻滞完善率均高于对照组(P<0.05)。研究组患者麻醉有效率高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。研究组患者麻醉总满意率高于对照组(P<0.05)。结论肥胖患者在肌间沟臂丛麻醉中,应用神经刺激仪联合超声的麻醉效果理想,起效快,镇痛持续时间长,神经阻滞完善,并发症少且安全性高。

Objective To investigate the application value of nerve stimulator combined with ultrasound in interscalene brachial plexus anesthesia in obese patients.Methods A total of 78 obese patients who were scheduled to use interscalene brachial plexus anesthesia in our hospital were selected as the research objects and divided into the control group and the study group according to the random number table method,with 39 cases in each group.Nerve stimulator was used in the control group,and nerve stimulator combined with ultrasound was used in the study group.The anesthesia completion time,anesthesia onset time,duration of analgesia,improvement rate of brachial plexus pain block,effective rate of anesthesia,incidence of complications and patient satisfaction were compared between the two groups.Results The anesthesia completion time and anesthesia onset time of the study group were shorter than those of the control group(P<0.05),and the duration of analgesia was longer than that of the control group(P<0.05).There was no significant difference in the improvement rate of radial nerve and musculocutaneous nerve block between the two groups(P>0.05),while the improvement rate of median nerve,ulnar nerve and medial forearm cutaneous nerve block in the study group was higher than that in the control group(P<0.05).The effective rate of anesthesia in the study group was higher than that in the control group(P<0.05),and the incidence of complications was lower than that in the control group(P<0.05).The total satisfaction rate of anesthesia in the study group was higher than that in the control group(P<0.05).Conclusion In the interscalene brachial plexus anesthesia of obese patients,the application of nerve stimulator combined with ultrasound has an ideal anesthesia effect,with rapid onset of anesthesia,long duration of analgesia,perfect nerve block,fewer complications and high safety.