臂丛神经阻滞应用解剖定位与超声引导的效果及费用比较  

Efficacy and costs comparison of anatomical landmarks and ultrasonic guidance during brachial plexus block

作　　者：金伟华[1] 王琛[1] 谢红[1] 

机构地区：[1]苏州大学附属第二医院麻醉科,江苏苏州215004

出　　处：《苏州大学学报（医学版）》2012年第2期245-248,253,共5页Suzhou University Journal of Medical Science

基　　金：苏州市第16批科技计划(社会发展)项目(SZD0613)

摘　　要：目的比较在臂丛神经阻滞时应用解剖定位与超声引导的效果及费用。方法择期上肢手术行臂丛神经阻滞患者80例,前瞻性随机分为A组(n=40,解剖定位行臂丛神经阻滞)和U组(n=40,二维超声显像实时引导臂丛神经阻滞)2组。记录麻醉操作时间、痛觉消失时间、镇痛持续时间;评价神经阻滞的成功率、优秀率及并发症;记录麻醉药费用和麻醉总费用。结果与A组比较,U组操作时间短,痛觉消失快,镇痛持续时间长,优秀率高(均P<0.05)。神经阻滞成功率A组为95.0%,U组为97.5%,差异无统计学意义(P>0.05)。A组有4例发生并发症,U组有2例发生并发症,差异无统计学意义(P>0.05)。麻醉药费用U组显著低于A组(P<0.01),麻醉总费用两组比较,差异无统计学意义(P>0.05)。结论与解剖定位法比较,超声引导臂丛神经阻滞麻醉操作时间短、起效快、镇痛时间长、阻滞效果更好,此方法适用于上肢手术且降低了麻醉药费用。Objective To compare the efficacy and costs of brachial plexus block （ BPB ） guided by ultrasound with that used anatomical landmarks. Methods Eighty ASA I or Ⅱ patients scheduled for upper extremity operation were prospectively randomized into 2 groups ： Group A （ n = 40, BPB using ana- tomical landmarks ） and group U （ n = 40, BPB guided in real time by a two-dimensional ultrasonic image）. The time spent on performing the block, the onset time and duration of analgesia were measured. The proportion of successful and excellent blocks and the incidence of complications were assessed. The cost of anesthetic and the total cost of anesthesia were recorded. Results Compared with group A, in group U the time spent on performing the block and the onset time of analgesia were significantly shorter, the duration of analgesia was significantly longer, the excellence rate of block was significandy higher （ all P 〈0.05）. 95.0% of patients in group A and 97.5% of patients in group U had a successful block （P 〉 0.05 ）. Four patients in group A and two patients in group U had occurred complications （P 〉 0.05 ）. The cost of anesthetic in group U was significantly less than in group A （ P 〈0.01 ）. There was no signifi- cant difference in the total cost of anesthesia between the two groups （ P 〉 0.05 ）. Conclusion BPB guided by ultrasound provides better block with more rapid performance and longer duration of analgesia as compared with that used anatomical landmarks. Ultrasound-guided BPB is suitable for upper extremity operation and lowers the anesthetic cost.

关 键 词：超声检查 臂丛 神经传导阻滞 费用 医疗 

分 类 号：R614.4[医药卫生—麻醉学]