超声和神经刺激器引导下双侧腋路臂丛神经阻滞的临床对比观察  

The clinical efficacy of bilateral axillary brachial plexus block guided by ultrasound or neurostimulator

作　　者：徐诚实[1] 郑媛芳 张文超[1] 杨庆国[1] 王怀江[1] 王庚[1] XU Cheng-shi;ZHENG Yuan-fang;ZHANG Wen-chao(Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing 100035, China)

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》2018年第1期11-14,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:比较超声和神经刺激器引导下双侧腋路臂丛神经阻滞在双侧前臂/手手术的麻醉效果及并发症的发生率。方法:选取北京积水潭院2012年2月~2014年3月间行双侧前臂/手手术患者120例。随机分为超声引导组(U组,n=60)和神经刺激器引导组(N组,n=60),均应用0.5%罗哌卡因进行双侧腋路臂丛神经阻滞。记录操作时间、感觉和运动阻滞起效时间、操作痛、患者满意度以及麻醉相关并发症的发生率。结果:所有患者麻醉效果均满足手术要求。超声引导组的操作时间、感觉和运动阻滞起效时间均明显短于神经刺激器引导组(P<0.01)。超声引导组的操作痛明显低于神经刺激器引导组(P<0.05)。超声引导组的患者满意度明显高于神经刺激器引导组(P<0.05),神经刺激器引导组的操作痛明显较超声引导组严重(P<0.01)。2组均未发现明显麻醉相关并发症。结论:超声和神经刺激器引导行双侧腋路臂丛神经阻滞均可达到满意的麻醉效果。与神经刺激器引导相比,超声引导下的双侧腋路臂丛神经阻滞操作时间短、起效快、疼痛较轻且患者满意度更高。Objective：To compare the clinical efficacy and the related complications of bilateral axillary brachial plexus block guided by ultrasound or neurostimulator in bilateral forearm/hand surgery.Methods：One hundred and twenty patients undergoing bilateral forearm/hand surgery from February 2012 to March 2014 were enrolled in this study.They were divided into two groups：the ultrasound group（group U,n =60）and the neurostimulator group（group N,n =60）.The brachial plexus block was performed with 0.5% ropivacaine.The performance duration,the onset of sensory and motor block,the performance-related pain,the satisfaction degree and the related complications were recorded and analyzed.Results：All blocks could meet operation requirements.The performance duration and the onset of sensory and motor block of group U were markedly less than those of group N（P〈0.05）.The satisfaction degree of group U was significantly higher than that of group N（P〈0.05）.The performance-related pain of group N was obviously serious than that of group U（P〈0.01）.No related complications were detected perioperatively.Conclusion：Both ultrasound-guided and neurostimulator-guided bilateral axillary brachial plexus block can supply satisfactory anesthetic efficacy.However,bilateral axillary brachial plexus block guided by ultrasound is superior because it is accompanied with less performance duration,faster onset,less performance-related pain and higher satisfaction degree.

关 键 词：臂丛神经阻滞 罗哌卡因 超声 神经刺激器 

分 类 号：R614.31[医药卫生—麻醉学]