超声引导下臂丛神经阻滞在上肢手术麻醉中的应用效果

Application effect of ultrasound-guided brachial plexus block in upper extremity surgery anesthesia

目的探讨超声引导下臂丛神经阻滞在上肢手术麻醉中的应用效果。方法选取2020年3月至2021年9月本院收治的120例上肢手术麻醉患者作为研究对象,随机分为对照组与观察组,每组60例。对照组行盲穿行臂丛神经阻滞法,观察组行超声引导下臂丛神经阻滞法,比较两组麻醉指标、视觉模拟评分法(VAS)评分、不良反应发生率。结果观察组感觉阻滞起效时间、运动阻滞起效时间均短于对照组,麻醉药物使用剂量少于对照组,差异有统计学意义(P<0.05)。两组VAS评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:两组术后各时间点VAS评分明显低于前一时间点,差异有统计学意义(P<0.05)。组间比较:术毕,两组VAS评分比较差异无统计学意义;术后6、12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为6.67%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论上肢手术麻醉中使用超声引导下臂丛神经阻滞方法效果显著,可降低患者疼痛感,缩短运动阻滞恢复时间,降低患者麻醉不良反应发生风险,值得临床推广应用。

Objective To investigate the application effect of ultrasound-guided brachial plexus block in upper extremity surgery anesthesia.Methods 120 patients with upper extremity surgery anesthesia admitted to our hospital from March 2020 to September 2021 were selected as the research subjects,and they were randomly divided into control group and observation group,with 60 cases in each group.The control group was treated with blind brachial plexus block,and the observation group was treated with ultrasound-guided brachial plexus block anesthesia,the anesthesia index,visual analogue scale(VAS)score,and the incidence of adverse reactions were compared between the two groups.Results The onset time of sensory block and motor block in the observation group was shorter than that in the control group,and the dosage of anesthetic drugs was less than that in the control group,the difference was statistically significant(P<0.05).There were significant differences of VAS scores between two groups,time and interaction(P<0.05).Comparison within the group:VAS scores of the two groups were significantly lower than those of the previous time point,and the difference was statistically significant(P<0.05).Comparison between the two groups:after the operation,there was no significant difference in VAS score between the two groups;at 6,12 and 24 h after operation,VAS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 6.67%,witch was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of ultrasound-guided brachial plexus block in upper extremity surgery anesthesia has significant effects,which can reduce the pain of patients,shorten the recovery time of motor block,and reduce the risk of adverse anesthetic reactions in patients,which is worthy of clinical promotion and application.