超声引导下锁骨上臂丛神经阻滞在桡骨骨折患者手术中的应用效果

Application Effect of Ultrasound-guided Supraclavicular Brachial Plexus Block in Patients with Radial Fractures

目的 探究超声引导下锁骨上臂丛神经阻滞在桡骨骨折手术中的效果。方法 抽取2020年1月—2021年6月该院桡骨骨折86例患者为研究对象,随机分为两组,每组43例。对照组予刺激仪引导下神经阻滞,观察组则予超声引导下锁骨上臂丛神经阻滞。对比两组阻滞、血流动力学指标及疼痛评分。结果 观察组阻滞持续时间(331.34±43.21)min长于对照组(267.45±35.76)min,阻滞完善时间(12.53±2.23)min及起效时间(4.48±1.02)min短于对照组(16.61±2.53)、(6.31±1.56)min,差异有统计学意义(t=-7.470、7.933、6.438,P<0.001);观察组T1、T2、T3平均动脉压(88.25±8.28)、(95.21±9.68)、(86.52±7.87)mmHg、心率(80.67±5.35)、(82.27±5.42)、(79.48±5.21)次/min低于对照组(97.53±9.09)、(105.52±11.13)、(101.77±9.35)mmHg、(86.13±6.32)、(89.08±6.46)、(86.07±8.17)次/min,差异有统计学意义(t=4.949、4.583、8.183、4.324、5.296、4.460,P<0.001);观察组术后6、24 h VAS评分(1.71±0.37)分、(1.76±0.49)分低于对照组(2.16±0.53)分、(2.21±0.64)分,差异有统计学意义(t=4.565、3.661,P<0.001)。结论 桡骨骨折患者术中实施超声引导下锁骨上臂丛神经阻滞效果理想。

Objective To explore the effect of ultrasound-guided supraclavicular brachial plexus block in radial fracture surgery.Methods A total of 86 patients with radial fractures in the hospital from January 2020 to June 2021 were selected as the study objects and randomly divided into two groups, 43 cases in each group. The control group was given nerve block under the guidance of stimulator, while the observation group was given ultrasound-guided supraclavicular brachial plexus block. The block, hemodynamic indexes and pain scores were compared between the two groups. Results The duration of block time in the observation group was(331.34±43.21) min longer than that in the control group(267.45±35.76) min, the block complete time(12.53±2.23) min and the onset time(4.48±1.02) min were shorter than those in the control group(16.61±2.53) min,(6.31±1.56) min, and the difference was statistically significant(t=-7.470, 7.933, 6.438, P<0.001). T1, T2, T3 mean arterial pressure(88.25±8.28) mmHg,(95.21±9.68) mmHg,(86.52±7.87) mmHg, heart rate(80.67±5.35) times/min,(82.27±5.42) times/min,(79.48±5.21) times/min in the observation group were lower than the control group(97.53±9.09) mmHg,(105.52±11.13) mmHg,(101.77±9.35) mmHg,(86.13±6.32) times/min,(89.08±6.46) times/min,(86.07±8.17) times/min, and the difference was statistically significant(t=4.949, 4.583, 8.183, 4.324, 5.296, 4.460, P<0.001). The VAS scores at 6 h and 24 h after operation(1.71±0.37) points and(1.76±0.49) points in the observation group were lower than those in the control group(2.16±0.53) points and(2.21±0.64) points, and the difference was statistically significant(t=4.565, 3.661, P<0.001). Conclusion Intraoperative ultrasound-guided supraclavicular brachial plexus block in patients with radial fractures has an ideal effect.