腋路不同置管途径对肘关节松解术后镇痛的影响  

Comparing the analgesic efficacy of different continuous axillary brachial plexus block approach after elbow joint release operation

作　　者：王怀江[1] 张大志[1] 张文杰[1] 

机构地区：[1]北京积水潭医院麻醉科,北京100035

出　　处：《中日友好医院学报》2016年第1期10-12,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:比较腋路不同置管途径对肘关节松解术后镇痛的影响。方法:90例患者被随机分为桡神经组(R组)、正中神经组(M组)和尺神经组(U组),每组30例。运用神经刺激器分别刺激桡神经、正中神经和尺神经后经过穿刺针置入导管。记录3组患者术后24h、48h、72h(静息和功能锻炼时)的数字疼痛分级法(NRS)评分,记录3组患者术后24h、48h和72h镇痛泵的舒芬太尼用量、按压总次数和有效次数。结果:R组的NRS不论是在静息状态下还是在功能锻炼时均比U组和M组显著降低(P<0.01),M组的NRS在术后各观察时点均比U组低,但差异无统计学意义。U组患者术后72h舒芬太尼的消耗量、按压总次数和有效次数显著高于M、R组(P<0.05)。结论 :肘关节松解术行腋路置管时在刺激桡神经后置管镇痛效果较好。objective：To compare the analgesic efficacy of different continuous axillary brachial plexus block after elbow joint release operation.Methods：Ninety patients were randomly allocated into three groups with 1：1：1 ratio,radial nerve group（R）,median nerve group（M）and ulnar nerve group（U）.In these corresponding groups,the catheter was placed when radial nerve,median nerve or ulnar nerve was stimulated.The numerical rating scale scores（NRS）were assessed at rest and on passive mobilization at 24 h,48h and 72 h after elbow joint release operation.All patients received patient-controlled analgesia（PCA）with sufentanil as adjuvant analgesia.The postoperative sufentanil consumption and PCA button press times were recorded at 24 h,48h and72 h.Results：There were significantly lower NRS scores at rest and on passive mobilization 24 h,48h and 72 h after operation in the R group than those in group U or group M（P〈0.01）.The postoperative sufentanil consumption and PCA button press times in group U were more than those in group M and group R（P〈0.05）at72h after operation.Conclusion：Radial nerve block is the most effective approach in controlling pain after elbow stiffness release operation.

关 键 词：罗哌卡因 腋路臂丛 肘关节松解术 

分 类 号：R614.4[医药卫生—麻醉学]