超声引导锁骨下与腋路臂丛神经阻滞在肘关节手术中的应用效果比较

Comparison of the Application Effect of Ultrasound Guided Infraclavicular and Axillary Brachial Plexus Block in Elbow Joint Surgery

目的:比较超声引导锁骨下臂丛神经阻滞(ICB)与腋路臂丛神经阻滞(AXB)在肘关节手术中的应用效果。方法:选择2021年1月—2022年12月佛山市中医院收治的140例拟行肘关节手术的患者为研究对象,按照随机数表法分两组,各70例。ICB组采用超声引导ICB,AXB组采用超声引导AXB。观察两组麻醉操作时间、麻醉起效时间、麻醉持续时间、穿刺次数、神经阻滞情况、麻醉成功率及并发症发生情况。结果:两组麻醉持续时间和麻醉操作时间比较,差异无统计学意义(P>0.05)。ICB组穿刺次数少于AXB组,麻醉起效时间早于AXB组,差异有统计学意义(P<0.05)。ICB组桡神经、肌皮神经阻滞有效率高于AXB组,差异有统计学意义(P<0.05)。ICB组麻醉成功68例,麻醉成功率为97.14%,AXB组麻醉成功66例,麻醉成功率为94.29%,两组麻醉成功率比较,差异无统计学意义(P>0.05)。两组术后穿刺异感、血管损伤、止血带反应等并发症发生率比较,差异无统计学意义(P>0.05)。结论:超声引导ICB与AXB在肘关节手术阻滞中均有较好的效果,且操作安全,但ICB更为迅速,临床可根据具体情况选择合适的麻醉阻滞方式。

Objective:To compare the effect of ultrasound guided infraclavicular brachial plexus block(ICB)and axillary brachial plexus block(AXB)in elbow joint surgery.Method:A total of 140 patients who planned to undergo elbow joint surgery admitted to Foshan Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were select as study objects,and they were divided into two groups by random table method,with 70 patients in each group.The ICB group used ultrasound guided ICB,while the AXB group used ultrasound guided AXB.Observed the anesthesia operation time,anesthesia onset time,anesthesia duration time,puncture frequency,nerve block situation,anesthesia success rate,and occurrence of complications between the two groups.Result:There were no statistically significant differences in the anesthesia duration time and anesthesia operation time between the two groups(P>0.05).The number of punctures in the ICB group was less than that in the AXB group,and the anesthesia onset time was earlier than that in the AXB group,the differences were statistically significant(P<0.05).The blocking effective rate of radial nerve and musculocutaneous nerve in ICB group were significantly higher than those in AXB group,the differences were statistically significant(P<0.05).A total of 68 cases were successfully anesthetized in the ICB group,the success rate was 97.14%,a total of 66 cases were successfully anesthetized in the AXB group,the success rate was 94.29%,but there were no statistically significant difference in the anesthesia success rates between the two groups(P>0.05).There were no significant differences between the two groups in the incidence of complications such as paracentesis,vascular injury and tourniquet reaction(P>0.05).Conclusion:Both ICB and AXB guided by ultrasound have good effect and safe operation in elbow joint surgery,but ICB is more rapid,and the appropriate anesthesia block method can be selected according to the specific situation in the clinic.