超声引导臂丛、肋间臂神经阻滞在上肢手术中的应用  

Application of Ultrasound-guided Brachial Plexus and IntercostalBrachial Nerve Block in Upper Limb Surgery

作　　者：林晓妹 陈汶 梁丹桂 曾秋谷 黎瑶瑶 LIN Xiaomei;CHEN Wen;LIANG Dangui;ZENG Qiugu;LI Yaoyao(Department of Anesthesiology,Yangjiang People’s Hospital,Yangjiang Guangdong 529500,China)

机构地区：[1]阳江市人民医院麻醉科,广东阳江529500

出　　处：《中国卫生标准管理》2021年第9期82-85,共4页China Health Standard Management

摘　　要：目的分析超声引导臂丛神经阻滞联合肋间臂神经阻滞在上肢手术中的临床应用。方法选取自2019年9月—2020年8月收治的100例需要上止血带的上肢成人手术患者作为试验对象,按照患者麻醉方式的不同分为常规组和试验组,对比分析两组患者术中各时间段的疼痛分级,术中止血带反应,记录术中镇痛不足需增加镇痛药和静脉麻醉药的例数和量及术中改行气管插管全麻方式的例数及其不良反应等。结果试验组患者各个时间段麻醉效果明显优于常规组患者,差异有统计学意义(P<0.05)。试验组患者止血带反应明显少于常规组患者,差异有统计学意义(P<0.05);试验组术中镇痛不足需增加镇痛药和静脉麻醉药的例数和量及术中改行气管插管全麻方式的例数明显少于常规组,差异有统计学意义(P<0.05)。试验组患者出现麻药中毒、喉返神经阻滞、血肿的几率与常规组患者差异无统计学意义(P>0.05)。结论对进行上肢手术的患者采用超声引导臂丛神经阻滞联合肋间臂神经阻滞进行治疗,麻醉效果显著,更有利于促进患者康复。Objective To analyze the clinical effect of ultrasound guided brachial plexus block combined with intercostal brachial nerve block in upper limb surgery.Methods 100 adult patients with upper extremity surgery who needed tourniquet from September 2019 to August 2020 were selected as experimental objects, and the patients were divided into theroutine group and the experimental group according to different anesthesiamethods. Then, the pain grade, tourniquet reaction, the number and amountof patients who needed to increase analgesics and intravenous anestheticsfor insufficient analgesia during operation, the number of cases of changingto general anesthesia by endotracheal intubation and the adverse reactionswere recorded. Results The anesthetic effect in the experimental group wassignificantly better than that in the routine group, and there was statisticalsignificance (P < 0.05). The tourniquet reaction in the experimental groupwas significantly less than that in the routine group, and there was statisticalsignificance (P < 0.05). The number and quantity of analgesic drugs andintravenous anesthetics needed to be increased, and the number of casesof tracheal intubation general anesthesia in the experimental group weresignificantly less than those in the routine group, and there was statisticalsignificance (P < 0.05). There was no significant difference in the incidenceof anesthesia poisoning, recurrent laryngeal nerve obstruction andhematoma between the experimental group and the routine group (P > 0.05).Conclusion The treatment effect ultrasound guided brachial plexus blockcombined with intercostal brachial nerve block is effective for patientsundergoing upper limb surgery are significant, and it is more conducive topromote the rehabilitation of patients.

关 键 词：超声引导臂丛神经阻滞 肋间臂神经阻滞 上肢手术 临床应用 疼痛评分 止血带反应 

分 类 号：R687[医药卫生—骨科学]