超声引导下与神经刺激器联合超声引导下腋路臂丛神经阻滞在下肘部位手术患者麻醉中应用比较

目的]比较神经刺激器联合超声引导及单纯超声引导行腋路臂丛神经阻滞在下肘部位手术患者麻醉中的应用效果.方法]60例下肘部手术患者,随机分为观察组和对照组,各30例.对照组给予超声引导下腋路臂丛神经阻滞方案,观察组则予以神经刺激器联合超声引导下腋路臂丛神经阻滞方案.比较两组受试者操作时间、相关神经阻滞的起效时间、神经阻滞持续时间及0.5 h内阻滞成功率、一次性穿刺成功率差异及相关并发症发生情况.结果]观察组0.5 h内臂丛神经阻滞总成功率显著高于对照组(100.0%vs 86.7%),相关并发症发生率则显著低于对照组(6.7%vs 26.7%),且差异均有显著性(P均<0.05).观察组平均操作时间及桡神经、尺神经、正中神经、肌皮神经等阻滞起效时间均显著低于对照组,神经阻滞持续时间则明显长于对照组(P均<0.05);两组一次性穿刺成功率比较差异无显著性(P>0.05).结论]对下肘部位手术患者予以神经刺激器联合超声引导下腋路臂丛神经阻滞方案,利于提高其定位准确性及臂丛神经阻滞成功率,对降低其手术相关并发症发生风险、延长其神经阻滞持续时间等具有积极影响.

Comparison of the Application of Ultrasound-guided and Nerve Stimulator-positioning Axillary Brachial Plexus Block in Anesthesia for Patients Undergoing Lower Elbow Surgery

Objective]To compare the application value between nerve stimulator positioning combined with ul-trasound-guided and simple ultrasound-guided axillary brachial plexus block in anesthesia for patients undergoing low-er elbow surgery. Methods]Sixty patients undergoing lower elbow surgery were selected as the study subjects and were divided into the observation group and the control group, with 30 cases in each. The control group was treated with ultrasound-guided axillary brachial plexus block while the observation group was treated with nerve stimulator po-sitioning combined with ultrasound-guided axillary brachial plexus block. The operation time, onset time of block of relevant nerves, duration of nerve block, success rate of block within 0.5h and success rate of one-time puncture were observed and compared between the two groups. The incidence of related complications was recorded. Results]The total success rate of brachial plexus block within 0.5h in the observation group was significantly higher than that in the control group (100.0% vs 86.7%), while the incidence of related complications was significantly lower than that in the control group (6.7% vs 26.7%) ( P< 0.05). The average operation time and block onset time of radial nerve, ulnar nerve, median nerve and musculocutaneous nerve of patients in the observation group were significantly shorter than those of control group, while the duration of nerve block was significantly longer than that of the control group ( P<0.05) . There was no significant difference in the success rate of one-time puncture between the two groups ( P>0.05) . Conclusion]The application of nerve stimulator combined with ultrasound-guided axillary brachial plexus block in patients undergoing lower elbow surgery can improve the accuracy of positioning and the success rate of axil-lary brachial plexus block. It has positive effects on reducing the risk of related complications and extending the dura-tion of the nerve block.