穿刺针导引技术在超声引导下臂丛神经阻滞中的应用

目的设计超声引导下臂丛神经阻滞时的穿刺针导引器,并在体外和临床上验证其效果。方法自制一个穿刺针导引器,其主要部分是一个双层的扇形不锈钢薄片。选择80例在臂丛神经阻滞下行上肢手术的患者,随机分为自由手组和导引组,每组40人。由四位麻醉医师实施在超声引导下臂丛神经阻滞(锁骨上入路),每位医师完成20例,10例用自由手技术,10例用穿刺针导引器引导技术。记录穿刺针的主观可视性、阻滞完成时间、临床效果以及麻醉医师和患者对臂丛神经阻滞的满意度。结果导引组的针的主观可视性显著优于自由手组(P<0.05);导引组的阻滞完成时间明显短于自由手组(P<0.01);麻醉医师使用导引技术的满意度高于使用自由手技术(P<0.05)。结论使用穿刺针引导技术更容易完成超声引导下臂丛神经阻滞。

Application of a ultrasound-guided needle for brachial plexus block

Objective To design a needle that can be guided by ultrasound for brachial plexus block (BPNB). Methods A guide needle whith double-layer fan-shaped slices was designed. Eighty patients undergoing a operation of upper extremity under BPB though superclavicular approach were assigned randomly to freehand group and guide needle group with 40 cases each. Subjective visibility of needle,the time for performance,the effect of blockage,and satisfactory degree of needle group anesthetists and patients were recorded. Results Subjective visibility of needle was better in needle group than that in freehand group (P<0.05).The time for performance was significantly shorter in needle group than that in freehand group (P<0.01). The satisfactory degree of anesthetists to use the guide needle technique was higher than that to use freehand technique(P<0.05). Conclusion The guide needle guided by ultrasound can facilitate the visualization of needle-passing during BPB.