高频超声引导下臂丛神经阻滞麻醉在上肢手术中的应用效果及安全性分析

Application effect and safety analysis of high-frequency ultrasound-guided brachial plexus block anesthesia in upper limb surgery

目的分析高频超声引导下臂丛神经阻滞麻醉在上肢手术中的应用效果及安全性。方法选取2019年6月至2021年6月本院接诊且行臂丛神经阻滞麻醉的80例上肢手术患者作为研究对象,按随机数字表法分为两组,每组40例。观察组行高频超声引导下臂丛神经阻滞麻醉,对照组行传统穿刺臂丛神经阻滞麻醉,比较两组间尺动脉血流动力学、麻醉相关指标、一次性穿刺成功率及并发症发生率。结果观察组尺动脉血流量[(123.56±26.86)ml/min]大于对照组[(78.57±24.96)ml/min],舒张末期血流速度[(30.17±7.55)cm/s]快于对照组[(24.47±4.28)cm/s],搏动指数(1.15±0.22)、阻力指数(0.46±0.10)均低于对照组[(2.34±0.74)、(0.97±0.17)],差异有统计学意义(P<0.05);但组间收缩期峰速度比较差异无统计学意义。观察组麻醉完成时间[(7.89±1.11)min]、阻滞起效时间[(3.10±0.77)min]均短于对照组[(11.74±1.26)、(5.58±1.09)min],麻醉持续时间[(7.84±1.35)h]长于对照组[(6.16±1.23)h],视觉模拟评分法(VAS)评分[(2.64±0.52)分]低于对照组[(3.76±0.84)分],差异有统计学意义(P<0.05);观察组一次性穿刺成功率(100.00%)高于对照组(90.00%),差异有统计学意义(P<0.05)。观察组并发症发生率(2.50%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论上肢手术患者行高频超声引导下臂丛神经阻滞麻醉效果显著,可改善患者尺动脉血流量,缩短麻醉完成时间、阻滞起效时间及麻醉持续时间,缓解患者疼痛,降低并发症发生率,安全性高,值得临床推广应用。

Objective To analyze the application effect and safety of high-frequency ultrasound-guided brachial plexus block anesthesia in upper limb surgery.Methods A total of 80 patients with upper limb surgery who were admitted to our hospital and underwent brachial plexus block anesthesia from June 2019 to June 2021 were selected as the research subjects,and they were divided into two groups according to the random number table method,with 40 cases in each group.The observation group was given high-frequency ultrasound-guided brachial plexus block anesthesia,and the control group was given traditional puncture brachial plexus block anesthesia,the ulnar artery hemodynamics,anesthesia-related indicators,onetime puncture success rate and the incidence of complications were compared between the two groups.Results The ulnar arterial blood flow([123.56±26.86]ml/min)was greater than that in the control group([78.57±24.96]ml/min),the end-diastolic blood flow velocity([30.17±7.55]cm/s)in the observation group was faster than that in the control group([24.47±4.28]cm/s),and pulsatility index(1.15±0.22),resistance index(0.46±0.10)were lower than the control group(2.34±0.74,0.97±0.17),and the difference was statistically significant(P<0.05);however,there was no significant difference in peak systolic velocity between the two groups.The completion time of anesthesia([7.89±1.11]min)and block onset time([3.10±0.77]min)in the observation group were shorter than those in the control group([11.74±1.26],[5.58±1.09]min),and the duration of anesthesia was([7.84±1.35]h)was longer than the control group([6.16±1.23]h),and the visual analogue scale(VAS)score([2.64±0.52]scores)was lower than that servation group(100.00%)was higher than that in the control group(90.00%),and the difference was statistically significant(P<0.05).The incidence of complications in the observation group(2.50%)was lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusion High-frequency ultrasound-guided brachial plexus block anesthesia in patients with upper limb surgery has significant effect,which can improve the blood flow of the ulnar artery,shorten the completion time of anesthesia,the onset time of the block and the duration of anesthesia,relieve the pain of the patient,and reduce the incidence of complications,it has high safety rate and is worthy of clinical application.