神经刺激仪协同超声双引导肌间沟臂丛神经阻滞在肥胖患者上肢手术中的应用  

The Application of Nerve Stimulator Combined with Ultrasound Dual-guided Intermuscular Groove Brachial Plexus Block in Upper Limb Surgery for Obese Patients

作　　者：李斌斌 应海峰 黎毓秋 Li Binbin;Ying Haifeng;Li Yuqiu(Taizhou Hospital of Zhejiang Province,Taizhou Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,浙江台州317000

出　　处：《医疗装备》2024年第17期11-14,18,共5页Medical Equipment

摘　　要：目的探讨神经刺激仪协同超声双引导肌间沟臂丛神经阻滞在肥胖患者上肢手术中的应用效果。方法选取2021年1月至2023年12月于医院择期行上肢手术的110例肥胖患者作为研究对象,采用随机双盲法分为两组,每组55例。对照组采用超声引导肌间沟臂丛神经阻滞,试验组采用神经刺激仪协同超声双引导肌间沟臂丛神经阻滞。比较两组神经阻滞起效时间、操作时间、神经阻滞持续时间、神经阻滞效果及穿刺并发症发生率。结果试验组肌皮神经、桡神经、正中神经及尺神经阻滞起效时间均短于对照组,差异均有统计学意义(P<0.05);试验组操作时间、神经阻滞持续时间均长于对照组,差异均有统计学意义(P<0.05);试验组神经阻滞优良率高于对照组,穿刺并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论神经刺激仪协同超声双引导肌间沟臂丛神经阻滞在肥胖患者上肢手术中的应用效果优于超声单独引导,可缩短神经阻滞起效时间、延长神经阻滞持续时间、提高神经阻滞效果,且穿刺并发症较少、安全性高,但操作时间较长,临床可根据具体情况选择阻滞方式。Objective To explore the application effect of nerve stimulator combined with ultrasound dual-guided intermuscular groove brachial plexus block in upper limb surgery for obese patients.Methods With the selection of 110 obese patients who underwent upper limb surgery at the hospital from January 2021 to December 2023 as the study subjects,they were randomly divided into two groups using a double-blind method,with 55 patients in each group.with the use of ultrasound-guided intermuscular groove brachial plexus block in the control group,and the use of nerve stimulators combined with ultrasound dual-guided intermuscular groove brachial plexus block in the experimental group,the onset time of nerve block,operation time,duration of nerve block,effect of nerve block and incidence of puncture complications were compared between the two groups.Results The onset time of musculocutaneous nerve,radial nerve,median nerve,and ulnar nerve block in the experimental group was shorter than that in the control group,and the differences were statistically significant(P<0.05);The operation time and duration of nerve block in the experimental group were longer than those in the control group,and the differences were statistically significant(P<0.05);The excellent rate of nerve block in the experimental group was higher than that in the control group,and the incidence of puncture complications was lower than that in the control group,with statistically significant differences(P<0.05).Conclusions The application effect of nerve stimulator combined with ultrasound dual-guidance for intermuscular groove brachial plexus nerve block in upper limb surgery of obese patients is superior to ultrasound guidance alone,which can shorten the onset time of nerve block,prolong the duration of nerve block,improve the effect of nerve block,and has fewer puncture complications and high safety.However,due to its long operation time,the clinical blocking method should be selected according to the specific situation.

关 键 词：神经刺激仪 超声 肥胖 臂丛神经阻滞 肌间沟 上肢手术 并发症 

分 类 号：R614[医药卫生—麻醉学]