超声引导下臂丛阻滞复合颈浅丛阻滞在锁骨骨折内固定术中的应用  

The Clinical Application of Brachial Plexus Block by Using Ultrasound Technique Combines Cervical Plexus Block for Internal Fixation of Clavicle Fracture

作　　者：游玉琼 徐红霞[2] 

机构地区：[1]湖北省洪湖市第三人民医院超声科,433200 [2]汕头大学医学院第二附属医院麻醉科,广东省汕头市515041

出　　处：《中华全科医学》2013年第1期70-70,93,共2页Chinese Journal of General Practice

摘　　要：目的探讨超声引导下臂丛阻滞复合颈浅丛阻滞在锁骨骨折内固定中的临床效果。方法 40例行锁骨骨折内固定的患者,ASAⅠ～Ⅲ级。随机均分为超声引导组(U组)和传统方法定位组(C组),各20例。局麻药均为0.375%罗哌卡因,其中臂丛神经阻滞用量25 ml,颈浅丛阻滞用量为5 ml。观察两组麻醉操作完成时间、感觉阻滞起效时间、感觉恢复时间,并评估麻醉效果。结果 U组麻醉完成时间、感觉阻滞起效时间明显短于C组(P<0.05或P<0.01),其麻醉效果明显优于C组。结论在锁骨骨折内固定手术中,超声引导下臂丛阻滞复合颈浅丛阻滞可缩短麻醉完成时间,延长麻醉作用时间,具有良好的麻醉效果,减少并发症的发生。Objective To observe the clinical application of brachial plexus block by using an ultrasound technique combine cervical plexus block for internal fixation of clavicle fracture. Methods Forty patients （ ASAⅠ～Ⅲ ） underwent internal fixation of clavicle fracture were randomly divided into 2 groups： group U （using real-time ultrasound image guiding） ;group C （anatomic mark）. 0. 375% ropivacaine were used respectively. The time of anesthesia completed,feeling-block starting,feeling return and the anesthesia effect were recorded. Results The time of anesthesia operation completed, and feeling-block starting in group U were obviously shorter than those of group C（ P 〈 0.05 or P 〈 0. 01 ）. The time of feeling return in group U were obviously longer than those of group C （ P 〈 0.05）. And the anesthesia effect was better in group U. Conclusion Brachial plexus block by using an ultrasound technique combines cervical plexus block was a safe and effective method with faster onset time, longer time of blockade, better anesthesia effect and less complication .

关 键 词：超声引导 臂丛阻滞 颈浅丛阻滞 锁骨骨折 

分 类 号：R614.4[医药卫生—麻醉学] R683.411[医药卫生—外科学]