喙突下臂丛神经阻滞用于骨科上肢手术的效应观察

目的观察用神经刺激仪定位喙突下臂丛神经阻滞的临床效应。方法将80例ASAⅠ~Ⅱ级骨科肘关节以下部位择期手术患者按照随机数字表达法分为喙突下组(A组)和腋路组(B组),每组40例。分别应用神经刺激仪进行喙突下和腋路途径施行臂丛神经阻滞。记录两组阻滞起效时间和维持时间;比较臂丛阻滞效果及感觉阻滞成功率;记录副作用;评价综合满意度。结果同样浓度容量的局麻药,阻滞起效时间A组较B组短(P0.05);维持时间两组间比较差异无统计学意义(P0.05)。桡神经、肌皮神经、腋神经、前臂内侧皮神经、正中神经感觉完全阻滞率A组为93.3%~100%,明显高于B组的60.0%~86.7%(P0.05);两组尺神经感觉完全阻滞率均为100%。两组均无副作用发生;综合满意度A组较B组高(P0.05)。结论用神经刺激仪定位喙突下臂丛阻滞操作简便,阻滞起效时间短,阻滞成功率高,效果确切。

Effect of subcoracoid brachial plexus block for orthopaedic upper extremity surgery

Objective To study the clinical effects of subcoracoid brachial plexus block for orthopaedic upper extremi-ty surgery with a nerve stimulator. Methods 80 cases of ASAⅠ-Ⅱelective orthopedic below elbow surgery were randomly divided into digital expression under the coracoid process（ group A） and axillary （ group B） , 40 patients in each group. All cases were carried out using a nerve stimulator under the coracoid process and the implementation of axillary brachial plexus block pathways, recording two block onset time and duration;comparing the effect of brachial plexus block and sensory block success rate; recording side effects and comprehensive evaluation satisfaction. Re-sults With the same volume of local anesthetic concentration, block onset time was shorter in group A than in group B （ P 〈0. 05 ） , and maintaining the time difference between the two groups was not statistically significant （ P〉0. 05）. Group A of radial, musculocutaneous, axillary, medial forearm, medial cutaneous nerve of the arm, the me-dian nerve sensory block success rate was 93. 3% -100%, significantly higher than group B 60. 0% -86. 7% （ P〈0. 05）;ulnar nerve barrier stagnation success rate was 100%. The occurrence of side effects were similar; Overall satisfaction group A was higher （P〈0. 05） than in group B. Conclusions With a nerve stimulator to locate the cor-acoid brachial plexus block is simple, block onset time is short, with high block success rate, and the exact effect.