肱骨近端骨折术中应用超声联合神经刺激仪行C4、C6横突阻滞麻醉效果评价

目的评价肱骨近端骨折术中应用超声联合神经刺激仪行C4、C6横突阻滞麻醉的效果及安全性。方法选择行肱骨近端骨折术患者90例,随机分为3组:超声联合神经刺激仪组(US组)30例、超声组(U组)30例、神经刺激仪组(S组)30例。US组采用C4、C6横突阻滞,U组、S组均采用颈丛联合肌间沟臂丛神经阻滞。比较3组的麻醉效果,麻醉操作时间、起效时间、维持时间及麻醉并发症。结果 US组麻醉效果明显优于U组及S组(P<0.05)。US组麻醉操作时间为(4.5±1.5)min,明显少于U组(6.1±1.2)min及S组(10.8±2.7)min(P<0.05)。US组麻醉起效时间为(10.6±1.5)min,明显少于U组(15.6±1.3)min及S组(18.0±1.6)min(P<0.05)。US组麻醉维持时间为(720±115)min,明显多于S组(508±101)min(P<0.05);与U组(715±113)min比较,差异无统计学意义(P>0.05)。US组麻醉并发症明显少于S组(P<0.05);与U组比较,差异无统计学意义(P>0.05)。结论肱骨近端骨折术中应用超声联合神经刺激仪行C4、C6横突阻滞麻醉效果良好,可缩短麻醉操作及起效时间、延长麻醉维持时间、减少并发症,是一种安全有效的麻醉方法。

Transverse process of C4 and C6 block guided by ultrasound combined with nerve stimulator in proximal humerus surgery

Objective To investigate the effect and safety of transverse process of C4 and C6 block guided by ultrasound combined with nerve stimulator in proximal humerus surgery. Methods A total of 90 patients underwent proximal humerus surgery were ran-domly divided into 3 groups with 30 cases in each group;patients in the Group US were guided by ultrasound combined with nerve stimulator,patients in the Group U were guided by ultrasound,and patients in the Group S were guided by nerve stimulator. In the Group US,nerve plexus block at the 4th and 6th cervical vertebra(C4 and C6)was performed;in the Group U and Group S,nerve plex-us block was performed to fix cervical plexus block and brachial plexus nerve block. The effectiveness of block,the time of performing the block, onset time of the anesthesia and duration of anesthesia, and the complications were observed among the three groups. Results The anesthetic effect in the Group US was significantly better than that in the Group U and Group S(P<0. 05). The time of performing the block in the Group US was (4. 5 ± 1. 5) minutes,which was significantly shorter than that in the Group U (6. 1 ± 1. 2) minutes and Group S (10. 8 ± 2. 7) minutes(P<0. 05). The onset time of the Group US was (10. 6 ± 1. 5) minutes,which was signif-icantly shorter than that in the Group U (15. 6 ± 1. 3) minutes and Group S (18. 0 ± 1. 6) minutes(P<0. 05). The duration of anes-thesia in the Group US was (720 ± 115) minutes,which was significantly longer than that in the Group S (508 ± 101) minutes( P<0. 05);compared with that in the Group US (715 ± 113) minutes,there was no statistical significance(P>0. 05). The complications of anesthesia in the Group US were significantly less than those in the Group S(P<0. 05);compared with those in the Group U,there was no statistical significance(P>0. 05). Conclusion Transverse process of C4 and C6 block guided by ultrasound combined with nerve stimulator in proximal humerus surgery is a safe and effective method with shorter performing and onset time,longer duration of blockade and less complications.