预置式高分辨率神经刺激阻滞仪的研制及临床应用  

The Study and Clinical Application of Present High-resolution Nerve Stimulating Block Apparatus

作　　者：崔永武[1] 韩林晓[1] 谢明娟[1] 曾俐敏[1] 郭晓秀[1] 张国顺[1] 段荣[1] 

机构地区：[1]内蒙古医学院第二附属医院麻醉科,内蒙古呼和浩特010030

出　　处：《内蒙古医学杂志》2004年第3期166-169,共4页Inner Mongolia Medical Journal

摘　　要：目的 :在相关的运动神经上施加一定量的电刺激脉冲电压 ,通过对该神经支配的肌纤维群的收缩效果来验证神经根的位置正确与否 ,及麻醉程度和施加电压的量化关系。方法 :在离穿刺部位较远区域安置无关电极与脉冲器连接 ,将刺激电流开至 1mA ,脉冲频率依需要可在 1Hz或 2Hz之间 ,然后用专用穿刺针按各类神经阻滞常规进行穿刺 ,观察所属神经支配区域肌肉群收缩情况 ,当出现与脉冲电流同步的神经所支配的肌肉收缩时 ,表明穿刺针接近或抵达神经干 ,此时将脉冲电流关至 0 5mA以下 ,所支配肌肉群仍在收缩 ,即注入麻药 1～ 3ml,肌群收缩停止 ,最后将所需麻药全部注入 ,再次将电流开至最大 5mA ,则无任何肌群收缩现象。结果 :脉冲电流 0 5mA以下仍有肌肉收缩现象 ,麻醉阻滞效果佳则在 96 %以上 ,尤其在 2次以上手术 ,实施基础麻醉后无主诉能力等穿刺定位困难者 ,该仪器有较可靠的客观指标。结论 :神经刺激阻滞仪可用于各种神经阻滞领域 ,手术、镇痛、封闭甚至可用于神经、肌肉阻滞恢复的监测等。Objective:To clear the location of nerve root through observing the effect of controlled musclar contraction with certain electrical pulse stimulating related motor nerve,and evaluate the relationship between anesthesia effect and voltage. Method: The electrode connected with pulse current apparatus was setted far away from the location of puncturing.When the stimulating current was adjusted to 1 mA,the pulse frequency ranged between 1Hz and 2Hz as required.The nerve block was performed by routine puncturing with special puncture needles,and the contraction of innervated muscle groups was observed.The current was turned down under 0.5 mv when the muscle contraction and pulse stimulation synchronized,which indicated that puncture was near or on nerve trunk.If the muscular contraction was continuous,anesthetic was injected about 1 to 3 ml until the constraction sttoped,then the remaining anestheticwas injected and the current was turned up no more than 5 mA.There was not muscular contraction. Results: The effective rate of anesthesic block was over 96% if there was still contraction of muscle groups with pulse current under 0.5mA.This apparatus could provide objective indictors for those difficult location of puncturing who are performed operations more than 2 times or less capacity of chief complaint after basal anesthesia. Conclusion: This nerve stimulating block apparatus is applicable to various herve block such as analgesia in operation,analgesia,obturation and even monitoring the recovery of nerve or muscle block.

关 键 词：预置式高分辨率 神经刺激阻滞仪 研制应用 麻醉学 

分 类 号：R246.2[医药卫生—针灸推拿学] R614.4[医药卫生—中医临床基础]