超声引导下臂丛复合肋间臂神经阻滞在肱骨内上髁骨折手术中的应用

目的 探讨臂丛神经阻滞+肋间臂神经阻滞在肱骨内上髁骨折手术中的临床效果.方法 将本院收治的需要进行肱骨内上髁骨折手术的患者60例,随机分为试验组和对照组,各30例,试验组患者麻醉方式选择臂丛神经阻滞+肋间臂神经阻滞,对照组选择臂丛神经阻滞的麻醉方式;以针刺法测定手术切口感觉阻滞效果并记录,注药后30min评价阻滞完善成功率.结果 对照组患者在手术中有7例需辅助静脉镇痛药,11例需要改为全麻,其余阻滞完善;试验组患者的麻醉效果良好,25例阻滞完善,4例需辅助静脉镇痛药,l例最后改为全麻完成手术;两组均未观察到局麻药中毒、气胸等并发症.结论 超声引导臂丛复合肋间臂神经阻滞可以安全地运用于肱骨内上髁的骨折,麻醉效果显著,可以在临床麻醉中进行推广.

Application of ultrasound-guided brachial plexus and intercostobrachial nerve block in surgery for medial epicondylar fracture of humerus

Objective To investigate the clinical effect of ultrasound-guided brachial plexus and intercostobrachial nerve block in surgery for medial epicondylar fracture of humerus.Methods 60 patients needing surgery for medial epicondylar fracture of humerus at our hospital were randomly divided into a treatment group and a control group,30 for each group.The treatment group took ultrasound-guided brachial plexus and intercostobrachial nerve block and the control group ultrasound-guided brachial plexus block.The block effect of surgery incision were detected by acupuncture and recorded.The success block rate was evaluated 30 min after injection.Results In the control group,7 cases were assisted with intravenous analgesic,11 cases were transferred for general anesthesia,and 12 cases had good anesthetic effect.In the treatment group,25 cases had good anesthetic effect and the operation was completed successfully,4 patients were assisted with intravenous analgesic,and 1 case was transferred for general anesthesia.No anesthetics,pneumothorax,etc.in both groups.Conclusions The application of ultrasound-guided brachial plexus and intercostobrachial nerve block in surgery for medial epicondylar fracture of humerus is safe and effective,so it is worth being clinically generalized.