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作 者:颜军 顾正松 冯云天 余彦 洪玉兰 YAN Jun;GU Zhengsong;FENG Yuntian;YU Yan;HONG Yulan(Department of Anesthesiology,Zhenjiang Hospital Affiliated to Nanjing University of Chinese Medicine,Zhenjiang Hospital of Traditional Chinese Medicine,Zhenjiang 212003,CHINA)
机构地区:[1]南京中医药大学镇江附属医院(镇江市中医院)麻醉科,江苏镇江212003
出 处:《江苏医药》2025年第2期138-141,共4页Jiangsu Medical Journal
摘 要:目的比较平卧位和侧卧位对超声引导肌间沟臂丛神经阻滞操作的影响。方法行超声引导肌间沟臂丛神经阻滞患者60例随机分为两组,每组30例。SP组采用平卧位操作,LP组采用侧卧位操作。局部麻醉药物均为0.5%罗哌卡因25mL。记录穿刺次数、穿刺针置入长度、操作时间和超声综合评分,比较两组阻滞起效时间和阻滞效果。评估操作者和患者满意度。结果与SP组比较,LP组超声综合评分良好比例较高(66.7%vs.50.0%),操作时间减少[(199.9±36.8)s vs.(261.9±50.3)s],穿刺针置入长度增加[(5.7±0.7)cm vs.(4.3±0.6)cm],穿刺次数减少[(1.2±0.5)次vs.(1.5±0.7)次](P<0.05)。两组呼吸困难患者比例、穿刺前和穿刺后15min的MAP和HR、阻滞起效时间和有穿刺针孔反应患者比例比较均无统计学差异(P>0.05)。SP组患者满意度评分较高,但LP组操作者满意度评分较高(P<0.05)。结论与平卧位比较,侧卧位进行超声引导肌间沟臂丛神经阻滞有利于操作者减少操作时间与穿刺次数,并且操作者体验感好,不易疲劳。Objective To compare the effects of supine position and lateral position on the ultrasound-guided interscalene brachial plexus block operation.Methods Sixty patients undergoing the ultrasound-guided interscalene brachial plexus block were randomly divided into two groups with 30cases each.The ultrasound-guided brachial plexus block was performed with 0.5%ropivacaine 25mL in both groups.The ultrasound-guided interscalene brachial plexus block operation was completed in supine position(group SP)or in lateral position(group LP).Times of punctures,needle insertion length,operation time and the total score of ultrasound were recorded.The time of block onset and block effect were compared between the two groups.The satisfactions of the operators and the patients to the operation were assessed.Results Compared with group SP,group LP had higher percentage of the patients with better total score of ultrasound(66.7%vs.50.0%),less operation time[(199.9±36.8)seconds vs.(261.9±50.3)seconds],longer needle insertion length[(5.7±0.7)cm vs.(4.3±0.6)cm]and less times of puncture[(1.2±0.5)times vs.(1.5±0.7)times](P<0.05).There were no statistical differences in the proportion of dyspnea,MAP and HR before puncture and 15 minutes after puncture,onset time and the proportion of the reaction to the puncture site between the two groups(P>0.05).The score of satisfaction of the patients was higher in group SP than that in group LP,which of the doctors was higher in group LP than that in group SP(P<0.05).Conclusion Compared with the supine position,the ultrasound-guided interscalene brachial plexus block in the lateral position helps the operator to reduce the operation time and puncture times,and the operator has a good experience and is not easy to fatigue.
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