低浓度局部麻醉药下肌间沟法联合腋路法臂丛神经阻滞的效果研究

目的探讨低浓度局部麻醉药下肌间沟法联合腋路法臂丛神经阻滞的临床应用价值。方法行上肢复杂手术治疗的患者66例,根据其麻醉方法不同,随机将患者分为对照组（36例）和联合组（30例）,其中两组患者用药量相同,对照组患者在较高浓度下行单纯肌间沟臂丛神经阻滞,联合组患者在较低浓度下行肌间沟联合腋路法臂丛神经阻滞,观察两组患者麻醉相关指标并进行统计学分析。结果联合组患者麻醉阻滞优良率100.00%明显高于对照组83.33%,差异有统计学意义（P〈0.05）;联合组患者麻醉后10、40 min,术毕10 min阻滞效果得分均明显高于对照组患者相应指标,差异均具有统计学意义（P〈0.05）;联合组患者并发症发生率低于对照组,差异具有统计学意义（P〈0.05）。结论低浓度局部麻醉药下肌间沟法联合腋路法臂丛神经阻滞在不增加药量的基础上,麻醉阻滞率大大提高,麻醉效果好,且并不增加麻醉并发症,值得在基层医院推广使用。

Effect analysis of interscalene combined with axillary approach in brachial plexus nerve block with low concentration local anesthesia

Objective To discuss the clinical application value of interscalene combined with axillary approach in brachial plexus nerve block with low concentration local anesthesia. Methods A total of 66 cases undergone upper limb complex surgery were randomly divided into control group （n=36） and combination group （n=30）, according to different anesthetic methods. Drug dosages of the two groups were the same. The control group was treated by interscalene brachial plexus nerve block alone under low concentration, and the combination group received interscalene combined with axillary approach in brachial plexus nerve block with low concentration. Anesthesia data of the two groups were observed and statistically analyzed. Results The good rate of anesthetic block of the combination group was 100.00%, which was higher than 83.33% of the control group. The difference had statistical significance （P〈0.05）. The block scores of 10 rain and 40 rain after anesthesia and 10 min after operation of the combination group were all higher than those of the control group. The differences was statistically significant （P〈0.05）. Incidence of complications in the combination group was lower than that of the control group, and the difference had statistical significance （P〈0.05）. Conclusion Under low concentration local anesthesia, interscalene combined with axillary approach in brachial plexus nerve block has high anesthesia block rate, good aesthetic effect, and few complications. It is worthy of clinical promotion and applicaiton.