颈5横突入路臂丛神经阻滞在肩部手术中的临床应用

目的：评价颈5横突入路肌间沟臂丛阻滞在肩部手术中的效果及安全性。方法：选择肩部手术60例，其中进行锁骨骨折手术32例，肩关节脱位手术8例，肱骨头及肱骨外髁颈骨折手术20例，随机分为两组，A组为对照组，为传统肌间沟阻滞；B组为改良肌间沟阻滞，经颈5横突水平入路。记录阻滞后30分钟各感觉神经阻滞情况，并评价阻滞效果，记录并发症情况。结果：B组优良率93．3％，A组优良率63．3％，B组较A组显著提高（P〈0．05）；B组对腋神经和C4神经阻滞效果较A组显著提高（P〈0．05）。结论：经颈5横突入路的肌间沟臂丛阻滞，定位简单，较传统肌间沟法对肩部手术阻滞的优良率明显提高，是一种安全、可靠的臂丛阻滞方法。

Clinical application of brachiai plexus block by C5 processus transversus approach undergoing shoulder surgery

Objective:To evaluate the value of brachial plexus block by C5 processus transversus approach undergoing shoulder surgery.Methods:60 ASA I or II adult patients undergoing shoulder surgeries were randomly divided into two groups.In group A( n=30),the patients received a routine method of intermuscular blocking anesthesia of brachialis plexus;In group B( n=30),the patients received a brachial plexus block by C5 processus transverses approach.0.25% ropivacaine injection was used as local anesthetic in two groups.The total of thir sensory distribution and the success rate of block were evaluated,then the complications were recorded.Results:The success rate in group B by C5 brachial plexus block was 93.3%,and significantly higher than that in group A(63.3%)(P<0.05).There was different sensory distribution between two groups.The success rate of axillary nerve and C4 block were higher in B group by C5 approach than in group A (P<0.05).Conclusion:Brachial plexus block by C5 processus transverses approach is simpler localization and greater success rate of block than routine myointergroove brachial plexus block for shoulder surgery.