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机构地区:[1]复旦大学附属华山医院麻醉科,上海200040
出 处:《中华手外科杂志》2013年第5期296-298,共3页Chinese Journal of Hand Surgery
摘 要:目的探讨改良(或修正)喙突入路和经典喙突人路定位对锁骨下臂丛神经阻滞的影响。方法对80例择期行臂丛神经阻滞手术的患者,随机分为2组,采用神经刺激器定位臂丛神经:A组以喙突内下2cm为穿刺点(经典组);B组穿刺点参考喙突内下2cm,并用臂丛神经体表的投影对该穿刺点进行修正(改良组)。记录两组患者操作时问、穿刺次数、阻滞成功率、并发症及患者的满意度。结果改良组的操作时间明显少于经典组(P〈0.01),且改良组无需调整阻滞针即可定位到臂丛神经的比例明显高于经典组(P〈0.05)。结论改良喙突入路可以明显提高单次穿刺定位到神经的概率,且可减少操作时间,提高了穿刺点体表定位的准确性。Objective To investigate th~ impact of the modified and classic coracoid approach for localization in the infraclavicular brachial plexus nerve block. Methods Eighty patients scheduled for elective surgical procedures under infraclavicular brachial plexus block were randomly divided into two groups. The puncture point of Group A was the classic Wilson's approach via the point 2 cm medial and caudal to the coracoid process. The puncture paint of Group B was modified by surface projection of the brachial plexus. Peripheral nerve stimulator was used to confirm the proper localization of the plexus. The performance time, the number of puncture, the anesthesia success rate, the incidence of complications and patient satisfaction were recorded. Results The performance time of the modified group was less than that of the classic group ( P 〈 0.01). The chance of locating the brachial plexus in a single puncture without adjusting the block needle was significantly higher in the modified group ( P 〈 0.05). Conclusion The modified coracoid approach can significantly improve the probability of locating the nerve in one puncture that reduces the performance time. It improves the accuracy of puncture point position on the body surface.
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