两种颈丛阻滞方法对锁骨手术麻醉镇痛效果和颈丛相邻神经阻滞并发症的影响  

Effect on Analgesic Efficacy and Complication of Neighboring Nerves Cervical Plexus Blockade of Two Cervical Plexus Block for Clavicle Surgery

作　　者：高申山[1] 黄绍农[1] 王显春[1] 陈建颜[1] 卢健芳[1] 

机构地区：[1]深圳市第二人民医院麻醉科,518035

出　　处：《岭南急诊医学杂志》2007年第3期191-192,共2页Lingnan Journal of Emergency Medicine

摘　　要：目的:比较两种不同颈丛阻滞方法对锁骨手术麻醉镇痛效果和颈丛相邻神经阻滞并发症的影响。方法:60例ASAⅠ-Ⅱ级,锁骨中段骨折拟在颈丛阻滞麻醉下接受手术的病人随机分成2组,每组30例。第一组病人麻醉的方法是行颈深丛与颈浅丛分别阻滞的方法(Ⅰ组)。用2%利多卡因10mL和0.75%罗哌卡因10mL混合成20mL,内含1∶200000肾上腺素,取10mL行颈深丛阻滞,另10mL行颈浅丛阻滞。第二组病人颈丛阻滞的方法是肌间沟法(Ⅱ组)。用上述20mL混合液直接在肌间沟的顶点内注射从而一次性阻滞颈神经丛。观察颈丛相邻神经阻滞并发症。麻醉镇痛效果不佳者追加局麻药或改行全身麻醉并终止连续VAS评分。结果:Ⅱ组麻醉镇痛效果优良率和颈丛相邻神经阻滞并发症发生率均高于Ⅰ组,P<0.05。结论:肌间沟法颈丛阻滞麻醉对锁骨手术非肥胖成年病人手术镇痛效果优于颈深丛与颈浅丛分别阻滞的方法,但其颈丛相邻神经阻滞并发症发生率也高。Objective： To compare both analgesic efficacy and complication of neighboring nerves cervical plexus blockade of two cervical plexus block for patients undergoing clavicle surgery. Methods： 60 patients, ASA Ⅰ - Ⅱ, scheduled for clavicle surgery after cervical plexus block anesthesia, were randomized into 2 groups, each group including 30 cases. Group Ⅰ received the combined deep and superficial cervical plexus block. Anesthetics were 20mL of the mixture of 10mL lidocaine 2% and 10mL ropivacaine 0.75%, containing adrenaline 1：200000. One half were injected to block deep cervical plexus, the other half were injected to block superficial cervical plexus. Group Ⅱ received the interscalene. Complications of neighboring nerves cervical plexus blockade were observed. Additional local anesthetics or converted into general anesthesia and VAS was stopped for bad analgesic efficacy patients. Results： Analgesic efficacies and complications of neighboring nerves cervical plexus blockade in group Ⅱ was significantly higher than that of group, each P 〈 0.05. Conclusion： The analgesic efficacy of interscalene cervical plexus block is better than that of combined deep and superficial cervical plexus block for the adult non-obese patients undergoing clavicle surgery,but the complications of neighboring nerves cervical plexus blockade is higher too.

关 键 词：颈丛阻滞 麻醉 神经阻滞 并发症 锁骨 

分 类 号：R614[医药卫生—麻醉学]