超声引导臂丛神经阻滞对肥胖病人上肢手术效果观察  

Effect of brachial plexus block guided by ultrasound on upper limbs surgery of obese patients

作　　者：杨川[1] 张玉荣[1] 谭首鹏[1] 

机构地区：[1]广元市第二人民医院麻醉科,四川广元628017

出　　处：《西部医学》2012年第6期1153-1155,共3页Medical Journal of West China

摘　　要：目的探讨超声引导肌间沟臂丛神经阻滞在肥胖病人上肢手术中的应用效果。方法选择择期上肢手术肥胖患者80例,随机均分成超声引导组(A组)和传统方法组(B组)两组,局麻药为0.5%罗哌卡因,总量≤0.5ml/kg。记录肌皮神经、桡神经、正中神经、尺神经阻滞的起效时间,并评价其阻滞完善率;评定麻醉效果(优、良、差),记录并发症。结果 A组各神经阻滞起效时间较短,而B组起效时间较长(P<0.01)。A组神经阻滞完善率均接近100%,明显高于B组(P<0.01)。A组麻醉效果优良率及优等率明显高于B组,差异有统计学意义(P<0.01)。A组有1例、B组有6例并发症,但两组均未出现严重后果。结论对肥胖病人,超声引导肌间沟臂丛神经阻滞效果确切,定位准确,安全性较高,值得临床推广应用。Objective To discuss the application effect of muscle ditch brachial plexus block guided by ultrasound in obese patients. Methods 80 cases of selective upper limbs surgery in obese patients were chosen and divided into two groups by stochastic and average （n=40 each）. In group A, block was guided by ultrasound. In group B, block was performed in traditional way 0. 5%. Ropivacaine was used as local anesthetic with a total dose ≤0. 5ml/kg. The onset time of block of musculocutaneous nerve, musculospiral nerve, median nerve and ulnar nerve were recorded and the block rate was evaluated. Anesthetic effect was assessed and the complications were recorded. Results The onset time of block of each nerve in group A was shorter than that in group B （P〈0.01）. The block rate in group A was approach 100%, which was obviously higher than that in group B （P〈0. 01）. The rates of anesthetic effect evaluated as excellent and effective were significantly higher than that in group B （P〈0.01）. There was 1 case of complication in group A and 6 cases of complications in group B, but there were no serious consequences in both groups. Conclusion Muscle ditch brachi- al plexus block guided by ultrasound in obese patients is effective with accurate positioning and high security.

关 键 词：超声引导 传统方法 臂丛神经阻滞 肥胖 

分 类 号：R614.4[医药卫生—麻醉学]