摘要
目的观察超声引导下臂丛神经阻滞在上肢手术中的麻醉效果。方法选取2015年2月～2016年2月我院收治的83例行上肢手术患者作为研究对象,采用随机数字表法将其分为传统组(41例)和超声组(42例)。两组患者均行局部麻醉,传统组患者应用传统的解剖穿刺定位,超声组患者在超声引导下穿刺定位。比较两组患者的麻醉操作完成时间、感觉阻滞起效时间、运动阻滞起效时间、视觉模拟评分(VAS)、术后应用镇痛药物例数、不良反应发生率及各分支神经支配区域阻滞情况。结果超声组患者的麻醉操作完成时间明显长于传统组,感觉、运动阻滞起效时间明显短于传统组,VAS评分及不良反应发生率明显低于传统组,差异有统计学意义(P<0.05);两组患者的术后镇痛药物应用率比较,差异无统计学意义(P>0.05)。超声组患者的尺神经阻滞程度轻于传统组,差异有统计学意义(P<0.05);两组患者的正中神经和桡神经阻滞情况比较,差异无统计学意义(P>0.05)。结论超声引导下进行臂丛神经阻滞与传统解剖定位的方式比较,虽然需要的操作时间更长,但麻醉起效时间更短,对尺神经阻滞效果更好,而且操作更为简单,不良反应少,费用低,可提高麻醉的有效性、准确性和安全性,具有较高的临床推广价值。
Objective To observe the anesthetic effect of ultrasound-guided brachial plexus block in upper limb surgery. Methods A total of 83 patients with upper limb surgery who were admitted to our hospital fi＇om February 2015 to February 2016 were selected as the research subjects, and they were divided into the traditional group （41 cases） and the ultrasound group （42 cases） according to the random number table method. Local anesthesia was performed in both groups. The traditional group was given traditional anatomical puncture positioning, and the ultrasound group was given ultrasound-guided puncture positioning. The anesthesia operation completion time, sensory block onset time, ex- ercise block onset time, visual analogue scale （VAS）, cases of postoperative anesthetic drugs, rate of adverse reaction and block situation of branch innervation area were compared between the two groups. Results The time of anesthesia operation completion in the ultrasound group was significantly longer than that in the traditional group, the onset time of sensory and motor block were significantly shorter than those in the traditional group, VAS score and the incidence of adverse reactions were signifieantly lower than those in the traditional group, and the differences were statistically significant （P〈0.05）. There was no statistically significant difference in the rate of receiving postoperative analgesic drugs between the two groups （P〉0.05）. The degree of ulnar nerve block in the ultrasound group was lighter than that in the traditional group, and the difference was statistically significant （P〈0.05）. There was no significant difference in the median nerve and radial nerve block between the two groups （P〉O.05）. Conclusion Ultrasound-guided braehial plexus block requires longer time than traditional anatomical positioning, but the onset time of anesthesia is shorter, which is better for ulnar nerve block. Moreover, the operation is simpler, the adverse reactions are less, and the cost is lower. It can improve the effectiveness, accuracy and safety of anesthesia and has a higher clinical promotion value.
作者
江英
叶贤瑞
黄丹慧
JIANG Ying;YE Xian-rui;HUANG Dan-hui(Department of Uhrasonography,People＇s Hospital of $hangli County,Jiangxi Province,Pingxiang 337009,China;Department of Anesthesiology,People＇s Hospital of shangli County,Jiangxi Province,Pingxiang 337009,China)
出处
《中国当代医药》
2018年第27期83-85,97,共4页
China Modern Medicine
关键词
上肢手术
臂丛神经阻滞
超声引导
麻醉效果
Upper limb surgery
Braehial plexus block
Ultrasound-guided
Anesthetic effect
