不同剂量局麻药对超声引导腋路臂丛神经阻滞效果的影响  

Effects of axillary approach brachial plexus blocking by ultrasound-guided with different dosage of local anesthetic

作　　者：施克俭[1] 刘付丽[1] 董晓西[1] 金烈烈[1] 徐旭仲[1] 

机构地区：[1]温州医学院附属第一医院麻醉科,325000

出　　处：《实用医学杂志》2010年第21期3881-3883,共3页The Journal of Practical Medicine

基　　金：温州市科技局科研基金资助项目(编号:Y2003A115)

摘　　要：目的:探讨不同剂量局麻药对超声引导腋路臂丛神经阻滞效果的影响。方法:90例择期行前臂和手部手术的患者,在超声引导下行腋路臂丛桡神经、正中神经、尺神经和肌皮神经阻滞,局麻药为2%利多卡因与0.75%罗哌卡因等容量混合液。随机分为A、B、C3组,每组30例,各组局麻药用量分别为每条神经8、6、4mL。记录桡神经、正中神经、尺神经、肌皮神经的感觉阻滞起效时间、麻醉持续时间和阻滞效果;评定手术全程的麻醉效果。结果:与C组比较,A组和B组各神经分支支配区麻醉起效时间较短(P<0.01),阻滞效果较好(P<0.01)。手术全程的麻醉效果评定:A组优秀29例,良好1例,麻醉优良率达100%;B组优秀28例,良好2例,麻醉优良率达100%;C组优秀11例,良好12例,失败7例,麻醉优良率76.7%,显著低于A组和B组(P<0.01)。麻醉持续时间A组和B组显著长于C组(P<0.01)。3组均无并发症。结论:超声引导腋路臂丛神经阻滞可以减少局麻药用量,是臂丛神经阻滞理想的引导方法。Objective To investigate the effects of axillary brachial plexus blocking under the guidance of ultrasound with different dosage of local anesthetic. Methods Patients scheduled for elective surgery of forearm and hands were randomLy divided to 3 groups （n = 30）. The radial, median, ulnar, and musculocutaneous nerves were blocked with axillary brachial plexus under the guidance of ultrasound. Local anesthetic was mixture with 2% lidocaine and 0.75% ropivacaine （1 ： 1 vol）. Each nerve was blocked with the mixture of 8 mL,6 mL and 4 mL respectively in group A, B and C. The onset time, duration of each nerves and effects of blockade were recorded. Effects of anesthesia were evaluated. Results The onset time of each nerve in group A and B was significantly shorter than that in group C （P 〈 0.01 ）. The anesthesia effect of excellent or well were 29 and 1 in group A, 28 and 2 in group B, 11 and 12 in group C, respectively. The success rate was 100%, 100% and 76.7% respectively in group A, B and C. The duration of anesthesia in group A and B was significantly longer than that in group C （P 〈0.01 ）.No complications occurred in all groups. Conclusion Dosage of local anesthetic is decreased with axillary approach brachial plexus blocking by ultrasound-guided.

关 键 词：麻醉 超声检查 臂丛 腋 

分 类 号：R614[医药卫生—麻醉学]