双点臂丛阻滞法用于上肢手术的临床观察

目的:观察研究臂丛神经阻滞双点法与单点法用于上肢手术时的麻醉效果,比较三组间神经阻滞效果、止血带反应和辅助用药情况。方法:选择90例上肢手术病人,ASAI-II级,手术时间2~5小时,按随机双盲法分为A、B、C三组,每组30例。A组:肌间沟臂丛神经阻滞法,使用0.3%罗哌卡因和1%利多卡因混合液20ml。B组:腋路臂丛神经阻滞法,使用0.3%罗哌卡因和1%利多卡因混合液20ml。C组:肌间沟臂丛神经阻滞联合腋路臂丛神经阻滞法,肌间沟阻滞使用0.3%罗哌卡因和1%利多卡因混合液20ml,同时腋路阻滞使用0.3%罗哌卡因和1%利多卡因混合液20ml。结果:双点阻滞法较单点阻滞法镇痛效果更完善,阻滞时间更长,止血带反应减少,基本未用辅助药。结论:双点阻滞法克服了单点法对尺侧或者桡侧阻滞不全的不足,止血带反应轻,病人舒适度过手术期。

Clinical observation of two-point brachial plexus block method on upper limb surgery patients

Objective:To observe the anesthetic effect between double points method and single point method of brachial plexus block on upper limb surgery patients,and to compare nerve block effect, tourniquet reaction and auxiliary drugs in three groups. Methods: 90 cases of upper limb surgery patients with ASAI-II grade and 2～5h operational time were divided into A, B,C three groups(30 cases in each group) according to a randomized double blind method. Group A: interscalene brachial plexus block,using mixture 20ml of 0.3% ropivacaine and 1% lidocaine. Group B: axillary brachial plexus block,using mixture 20ml of 0.3% ropivacaine and 1% lidocaine. Group C: interscalene brachial plexus block combined with axillary brachial plexus block method, using respectively mixture 20ml of 0.3% ropivacaine and 1% lidocaine. Results:Compared with single point brachial plexus block,analgesia effect of double block method was more perfect,block time was longer,the tourniquet reaction decreased,and usage amoun of auxiliary medicine was basically unused. Conclusion: Double point method overcomes the block insufficiency of single point method for ulnar or radial and tourniquet reaction is lighter,which is comfortable for patients through the operation period.