锁骨手术的三种神经阻滞麻醉效果比较  

Comparison of the analgesic effects for three kinds of nerve block on collarbone surgery

作　　者：谢少锋[1] 王忱[1] 刘怀萍[1] 邱树彬[1] 

机构地区：[1]汕头大学医学院第二附属医院麻醉科,广东汕头515041

出　　处：《海南医学》2007年第3期45-46,共2页Hainan Medical Journal

摘　　要：目的比较锁骨手术的三种神经阻滞的麻醉效果。方法60例锁骨手术患者随机分为三组,每组20例。A组行颈丛阻滞,B组行臂丛阻滞,C组行颈丛加臂丛联合阻滞,三组用相同局麻药(1%利多卡因、0.25%布比卡因混合液)。连续监测血压(BP)、脉搏血氧饱和度(SPO2)、心电图(ECG),分别记录麻醉前、麻醉后15min、切皮时、骨折复位时4个时点SBP,HR、SPO2的数值。记录各组麻醉效果及并发症。结果A、B、C组麻醉优良率分别为65%、65%、95%,C组与A或B组比较差异有显著性(P<0.05)。A、B、C组需辅助镇痛药者分别有13、14和1例,C组与A或B组比较差异有显著性(P<0.01)。C组患者手术期间SBP,HR变化小,与A、B组比较差异有显著性(P<0.05)。三组患者的SPO2均>97%,A组和C组各有1例出现霍纳氏综合症,A组有1例声音稍嘶哑,15min内自行消失,各组随访一周未发现其他并发症。结论对于锁骨手术,颈丛加臂丛联合阻滞比单独颈丛阻滞或臂丛阻滞效果好。Objective To compare the analgesic effects of three kinds of nerve block on collarbone surgery. Methods 60 patients, ASA physical status of Ⅰ-Ⅱ, undergoing collarbone surgery were randomly allocated into three groups： Group A was given cervical plexus nerve block （CPNB）; Group B was given brachial plexus block （BPNB）; Group C was given CPNB combination with BPNB. All patients were use the same local anaesthetic drugs （1%Lidocaine and 0.25% bubivacaine）, The BP, SPO2 and ECG were simultaneously monitored, The analgesia effects and complications were recorded. Results The satisfactory analgesia ration were 95% in group C, and 65% in group A or B, group C was significantly higher than group A or B（P〈0.05）. The cardiovascular respanse to operative stimulation was mild, systolic blood pressure and heart rate were not significantly different compared with those before operative in group C （p〉0.05）, which were significantly incread in group A and B （p〈0.05）, complications occurred 1 cases in group A and C, 0 cases in group B. Conclusions CPNB combination with BPNB provides better analgesia effect for collarbone surgery than CPNB or BPNB alone.

关 键 词：锁骨骨折 神经阻滞 颈丛 臂丛 

分 类 号：R614[医药卫生—麻醉学]