超声引导下臂丛神经阻滞麻醉在上肢骨科手术中的应用效果及安全性

Effect and safety of brachial plexus block anesthesia guided by ultrasound in upper limb orthopedic surgery

目的探讨超声引导下臂丛神经阻滞麻醉在上肢骨科手术中的应用效果及安全性。方法回顾性纳入河南科技大学附属许昌市中心医院2018年2月至2020年8月收治的需行上肢骨科手术的患者152例。根据麻醉方式将纳入患者分为盲探臂丛神经阻滞麻醉组74例和超声引导下臂丛神经阻滞麻醉组78例。比较两组麻醉效果、神经阻滞麻醉的相关指标和麻醉相关并发症发生情况。结果超声引导下臂丛神经阻滞麻醉组麻醉有效率为97.4%(76/78),高于盲探臂丛神经阻滞麻醉组的79.7%(59/74),P<0.05。与超声引导下臂丛神经阻滞麻醉组相比,盲探臂丛神经阻滞麻醉组阻滞起效时间较长,而镇痛持续时间较短,麻醉药使用剂量较高,差异有统计学意义(P<0.05)。超声引导下臂丛神经阻滞麻醉组并发症发生率(2.6%,2/78)低于盲探臂丛神经阻滞麻醉组(13.5%,10/74),差异有统计学意义(χ^(2)=6.261,P=0.012)。结论与盲探臂丛神经阻滞麻醉比较,超声引导下臂丛神经阻滞麻醉在上肢骨科手术中麻醉效果较好,神经阻滞麻醉的相关指标较好,麻醉相关并发症发生率低。

Objective To investigate the effect and safety of brachial plexus block anesthesia guided by ultrasound in upper limb orthopedic surgery.Methods A total of 152 patients who needed upper limb orthopedic surgery hospitalized in Xuchang Central Hospital Affiliated to Henan University of Science and Technology from Feburary 2018 to August 2020 were included retrospectively.They were divided into blind brachial plexus block anesthesia group(74 cases)and ultrasound-guided brachial plexus block anesthesia group(78 cases)by anesthesia methods.The anesthetic effect,related indexes of nerve block anesthesia,and incidence of anesthesia related complications were compared between the two groups.Results The effective rate of ultrasound-guided brachial plexus block anesthesia group was 97.4%(76/78),higher than the 79.7%(59/74)of blind brachial plexus block anesthesia group(P<0.05).Compared with ultrasound-guided brachial plexus block anesthesia group,blind probing brachial plexus block anesthesia group had significantly longer onset time,shorter duration of analgesia,and higher dosage of anesthetic(all P<0.05).The incidence of complications in ultrasound-guided brachial plexus block anesthesia group(2.6%,2/78)was significantly lower than that in blind brachial plexus block anesthesia group(13.5%,10/74),χ^(2)=6.261,P=0.012.Conclusions Compared with blind brachial plexus block anesthesia,ultrasound-guided brachial plexus block anesthesia has a better anesthetic effect in upper limb orthopedic surgery,better related indexes of nerve block anesthesia,and lower incidence of anesthesia-related complications.