持续臂丛神经阻滞用于上肢手术术后镇痛的疗效观察  

Curative Effect Observation of the Continuous Brachial Plexus Block is Used to Postoperative Analgesia After the Upper Limb Surgery

作　　者：黄丽萍[1] 王志力[1] 王庆涛[1] 王树祥[1] 陈娟[1] 李红开 

机构地区：[1]四川省江油市903医院麻醉科,621700

出　　处：《医学理论与实践》2012年第14期1690-1691,1695,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨静脉留置针行持续臂丛神经阻滞镇痛(CPNA)在上肢手术术后疼痛的临床疗效及经验总结。方法:将我院麻醉科2011年3-5月收治的38例行上肢手术且接受术后镇痛的患者随机分为CPNA组(持续臂丛神经阻滞镇痛)与PCSA组(皮下自控镇痛)。CPNA组采用静脉留置针于肌间沟穿刺,予以持续臂丛神经阻滞镇痛;PCSA组患者采用皮下注射舒芬太尼自控镇痛。手术结束后4、12、24、48h行静态和动态疼痛视觉模拟评分(VASr、VASm),同时观察不良反应。结果:术后4个时间点CPNA组VAS评分明显低于PCSA组,术后不良反应发生率低于PCSA组,差异均有统计学意义(P<0.05)。结论:上肢手术后持续臂丛神经阻滞镇痛(CPNA)效果满意,不良反应发生率低,适于临床应用。Objective：To study the clinical effects and the skills summary of continuous perineural block analgesia（CPNA） through a perivasculer catheter after the upper limb surgery analgesia. Methods： Randomly divide the 38 patients into group CPNA and group PCSA（patient-controlled subcutaneous analgesia）, who had received upper limb surgeries and the patient controlled analgesia from March 2011 to May in our anesthesia department. Patients in group CPNA were placed vein-indwelling needles at interscalene sulcus and received PCA at postoperatiorL Patients in group PCSA were received patient-controlled subcutaneous analgesia with sufentanil. Visual analogue scales rest （VASt） ,visual ana-logue scales move（VASm） and the adverse effects were observed at 4,12,24,48 hours after surgery. Results： VAS of group CPNA is far lower than group PCSA at the 4 time points after surgery, and the occurring frequency of adverse effects is lower as well. All differences have statistical significance （P〈0.05）. Conclusion： CPNA after upper limb surgery is quite satisfactory with lower occurring frequency of untoward effect. So,it is adaptable to clinical application.

关 键 词：上肢手术 持续臂丛神经阻滞 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]