超声引导肌间沟臂丛神经阻滞术的临床应用  

Clinical application of ultrasound guided interscaiene brachial plexus block

作　　者：单立刚[1] 马多[2] 刘永前[1] 

机构地区：[1]福建省厦门市第二医院集美总院麻醉科,361021 [2]福建省厦门市第二医院集美总院超声影像科,361021

出　　处：《中国实用医刊》2012年第15期31-33,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨超声引导肌间沟臂丛神经阻滞定位的临床应用。方法选择上臂、前臂、手腕、手掌桡侧手术患者124例，随机分为筋膜突破（FP）、异感（PAR）、外周神经刺激器（PNS）、超声引导（UG）4种定位方法行肌间沟臂丛神经阻滞并预置动脉穿刺针套管备用术后镇痛。记录各组感觉神经阻滞起效时间、术中追加地佐辛与得普利麻剂量、并发症、术后患者自控镇痛（PCA）各时段按压次数、48h总按压次数、PCA辅助追加地佐辛剂量。结果UG组感觉神经阻滞起效时间5～11（10．5±4．3）min，与FP组17—22（20．4±3．8）min、PAR组15—20（17．2±2．6）min、PNS组15～18（16．7±1．5）rain比较，差异有统计学意义（P〈0．05）。术中辅助追加地佐辛剂量，UG组0．5～0．7（0．6±0．2）mg，与FP组5～15（10．5±4．7）mg、PAR组4～9（5．7±1．4）mg、PNS组4—8（5．0±2．3）mg比较，差异有统计学意义（P〈0．05）。得普利麻剂量，UG组与FP组、PAR组、PNS组比较，差异有统计学意义（P〈0．05）。UG组并发症减少，差异有统计学意义（P〈0．05）。术后PCA按压次数，UG组与FP、PAR、PNS组比较，明显减少，差异有统计学意义（P〈0．05）。地佐辛追加剂量降低，差异有统计学意义（P〈0．05）。结论超声引导肌间沟臂丛神经阻滞，可以缩短感觉神经阻滞起效时间、提高麻醉效果、减少并发症，优化术后镇痛。Objective To investigate the clinical application of ultrasound guided interscalene brachial plexus block. Methods One hundred and twenty-four patients underwent surgery of forearm, wrist, hand or fingers were randomly divided into four groups, with 31 cases in each group： group facial pop （FP）, group paresthesia （PAR）, group peripheral nerve stimulation （PNS） , group ultrasound-guided（UG）. The extent of sensory and motor blockade of each innervated region was assessed by scale scores, the anesthetic effects of surgical field and complications were observed and recorded. The effects of PCA and drug doses were compared. Results There were significant differences in sensory, drug doses, complications, painter control anesthsia between group UG with group FP, PAR, PNS （P 〈 0.05）. Conclusions Ultrasound-guided interscalene brachial plexus block is safe and can improve the success rate, reduce complications, relieve postoperative pain and decrease the need of dezocine after surgery.

关 键 词：超声引导 肌间沟臂丛阻滞 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]