超声引导上臂中段神经阻滞对手外科日间手术患者上肢运动功能的影响  

Effect of ultrasound-guided mid-humeral block on motor function of upper extremities of patients undergoing day-case surgery in a department of hand surgery

作　　者：朱微娟 周日永[1] 王权光[1] 鲍娜娜[1] 徐旭仲[1] 

机构地区：[1]温州医科大学附属第一医院麻醉科,325000

出　　处：《中华麻醉学杂志》2017年第3期267-270,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价超声引导上臂中段神经阻滞对手外科日间手术患者上肢运动功能的影响。方法择期行手部、腕部、前臂手术患者30例，体重50-75kg，年龄18～64岁，ASA分级I-Ⅲ级，采用随机数字表法分为2组（n=15）：I组行超声引导上臂中段的神经阻滞；Ⅱ组行超声引导锁骨上臂丛神经阻滞。均使用0．375％罗哌卡因25m1。记录阻滞起效时间、感觉功能恢复时间、肩和肘关节运动功能恢复时间和允许出院时间，记录患者满意度。结果与Ⅱ组比较，I组阻滞起效时间、肘关节及肩关节运动功能恢复时间和允许出院时间缩短，患者满意度升高（P〈0．01）。2组感觉功能恢复时间比较差异无统计学意义（P〉0．01）。结论超声引导上臂中段神经阻滞较锁骨上臂丛神经阻滞起效时间短，对上肢运动功能影响小。Objective To evaluate the effect of ultrasound-guided mid-humeral block on the motor function of upper extremities of the patients undergoing day-case surgery in a department of hand surgery. Methods Thirty patients, weighing 50-75 kg, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ -Ⅲ , scheduled for elective hand, wrist or forearm surgery, were divided into group I （n= 15） and group Ⅱ （n= 15） using a random number table. Ultrasound-guided mid-humeral block was performed in group I , and ultrasound-guided supraclavicular brachial plexus block was performed in group II , both with 0. 375% ropivacaine 25 ml. The onset time of sensory block, recovery time of sensory function, recovery time of motor function of shoulder and elbow joints, allowable hospital discharge time and patient＇s satisfaction were recorded. Results Compared with group II , the onset time of sensory block, recovery time of motor function of shoulder and elbow joints and allowable hospital discharge time were sig- nificantly shortened, and the degree of patient＇s satisfaction was increased in group I （P〈0. 0l）. There were no significant differences in the recovery time of sensory function between the two groups （ P 〉0. 01 ）. Conclusion Ultrasound-guided mid-humeral block has shorter onset time and less influence on the motor function of upper extremities than ultrasound-guided supraclavicular brachial plexus block in the patients un- dergoing day-case surgery in a department of hand surgery.

关 键 词：超声检查 神经传导阻滞 上肢 运动活动 

分 类 号：R614[医药卫生—麻醉学]