三角肌运动反应用于小儿经肌间沟臂丛神经阻滞的临床观察

目的为三角肌运动反应作为在外周神经刺激器定位下小儿经肌间沟臂丛神经阻滞终点的临床应用提供参考。方法60例拟行上肢手术患儿,在外周神经刺激器定位下行经肌间沟臂丛神经阻滞,随机分为3组:A组(20例),三角肌运动反应终点组;B组(20例),肱二头肌运动反应终点组;C组(20例),三角肌和肱二头肌运动反应终点组。比较各组在刺激域电流、获得终点时间、合作患儿运动阻滞起效时间及神经阻滞效果的差异。结果组间刺激域电流、运动阻滞起效时间、神经阻滞效果差异无统计学意义(P>0.05);A、B组获得终点时间大于C组(P<0.05)。结论三角肌运动反应终点可以作为小儿经肌间沟臂丛神经阻滞穿刺针正确定位的标志。

A clinical observation of deltoid motor response in interscalene brachial plexus block in children

Objective To provide a clinical reference that deltoid motor response be an endpoint in interscalene brachial plexus block with PNS in children.Methods Sixty children scheduled for upper limbs surgery under interscalene brachial plexus block with PNS were randomly divided into group A:endpoint of deltoid motor response; group B:endpoint of biceps motor response;group C:endpoint of deltoid and biceps motor response.The threshold current of stimulation,time to acquirement of endpoint,time to onset of motor block in cooperative children and effect of nerve block were compared among the groups.Results The threshold current of stimulation,time to onset of motor block in cooperative children and effect of nerve block had no significant difference among the groups (P>0.05).Time to acquirement of endpoint in groups A and B was significantly longer than in group C (P<0.05).Conclusion Deltoid motor response endpoint can indicate accurate needle placement in interscalene brachial plexus block in children.