B超定位下肌间沟臂丛神经阻滞在上肢骨折手术麻醉中的应用效果及安全性

Application Effect and Safety of Interscalene Brachial Plexus Block Under B-ultrasound Localization in Anesthesia of Upper Limb Fractures Surgery

目的研究B超定位下肌间沟臂丛神经阻滞在上肢骨折手术麻醉中的应用效果及安全性。方法选取2021年1月-2022年10月我院接诊的64例上肢骨折患者为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组采用传统臂丛神经阻滞麻醉,观察组采用B超定位下肌间沟臂丛神经阻滞麻醉,比较两组麻醉效果、麻醉临床手术指标、尺动脉血流动力学指标、疼痛评分、不良反应发生率。结果观察组麻醉优良率为93.75%,高于对照组的81.25%(P<0.05);观察组麻醉阻滞起效时间、麻醉完成时间短于对照组,麻醉持续时间长于对照组(P<0.05);观察组阻力指数、搏动指数均小于对照组,血流量大于对照组(P<0.05);观察组疼痛评分低于对照组(P<0.05);观察组不良反应发生率为6.25%,低于对照组的18.75%(P<0.05)。结论在上肢骨科手术麻醉中采用B超定位下肌间沟臂丛神经阻滞可提高麻醉效果,缩短麻醉阻滞、麻醉操作时间,延长麻醉持续时间,降低疼痛评分、不良反应发生率,且对尺动脉麻醉更完全,可改善外周血流量,是一种安全、有效的麻醉方式。

Objective To study the application effect and safety of interscalene brachial plexus block under B-ultrasound localization in anesthesia of upper limb fracture surgery.Methods From January 2021 to October 2022,64 patients with upper limb fractures admitted to our hospital were selected as the research objects.They were divided into control group and observation group by random number table method,with 32 patients in each group.The control group was treated with traditional brachial plexus block anesthesia,and the observation group was treated with intermuscular sulcus brachial plexus block anesthesia under B-ultrasound positioning.The anesthesia effect,anesthesia clinical operation index,ulnar artery hemodynamics index,pain score and incidence of adverse reactions were compared between the two groups.Results The excellent and good rate of anesthesia in the observation group was 93.75%,which was higher than 81.25%in the control group(P<0.05).The onset time of anesthesia block and completion time of anesthesia in the observation group were shorter than those in the control group,and the duration of anesthesia was longer than that in the control group(P<0.05).The resistance index and pulsatility index of the observation group were lower than those of the control group,and the blood flow was higher than that of the control group(P<0.05).The pain score of the observation group was lower than that of the control group(P<0.05).The incidence of adverse reactions in the observation group was 6.25%,which was lower than 18.75%in the control group(P<0.05).Conclusion Interscalene brachial plexus block under B-ultrasound localization can improve the anesthetic effect in upper limb orthopedic surgery,shorten the time of anesthesia block and anesthesia operation,prolong the duration of anesthesia,reduce the pain score and the incidence of adverse reactions,and the ulnar artery anesthesia is more complete,which can improve peripheral blood flow.It is a safe and effective anesthesia method.