超声引导锁骨上臂丛神经阻滞的临床应用

目的比较超声引导锁骨上臂丛神经定位与单纯手法解剖学定位行肌间沟臂丛神经阻滞的效果及安全性。方法选择拟行上肢手术的患者120例,ASAⅠ或Ⅱ级,随机均分为超声引导锁骨上臂丛神经定位组(Ⅰ组)和单纯手法解剖学定位组(Ⅱ组)。局麻药为0.75%罗哌卡因与2%利多卡因等量混合液,剂量为0.4 mL/kg。观察操作时间、起效时间、手术区域麻醉效果(优、良、失败)、持续时间,观察并记录并发症。结果Ⅰ组完成操作所需时间(185±102)s,明显短于Ⅱ组的(378±105)s(P<0.01)。Ⅰ组感觉阻滞起效时间明显快于Ⅱ组(P<0.01)。麻醉效果优等率Ⅰ组为96%,Ⅱ组为75%(P<0.05),有统计学意义。Ⅰ组未出现并发症,Ⅱ组有4例患者出现与神经阻滞相关的并发症。结论超声引导下行锁骨上臂丛神经阻滞操作时间短,阻滞起效快,效果好,并发症少。

Application of Ultrasound-guided Supraclavicular Brachial Plexus Block

Objective To compare the efficacy and safety of supraclavicular brachial plexus block under the guidance of ultrasonagraphy with that of conventional technique.Methods 120 ASA classⅠorⅡpatients scheduled for upper extremity operation were randomized to groupⅠand groupⅡwith 60 cases respectively.0.4 mL/kg of 0.75% ropivocaine and 2% lidocaine were administered in both groups.The identification time for the target nerves,the execution time,the onset time and duration of sensory blockade were recorded.The extent of sensory block of each in enervated region and the anesthetic effect of surgical field(rated as excellent,good and failure) were both assessed.The complications were observed and recorded as well.Results The execution time in group was(185±102) seconds,which was significantly shorter than that in group Ⅱ (378±105) seconds](P<0.01).The excellent rate of anesthetic effect of surgical field was 96% in group and 75% in groupⅡ(P<0.05).No major complication occurred in group Ⅰ,while 4 adverse events occurred in group Ⅱ.Conclusion Ultrasound-guided supraclavicular brachial plexus block may shorten the execution time and the onset time,and provide excellent block with fewer complications.