神经刺激器提高声引导下的腋路臂丛阻滞成功率.doc

神经刺激器提高超声引导下的腋路臂丛阻滞成功率 张大志 王庚 王晓琳 李玉锦 张文超 杨晓宇 【摘要】　目的　比较神经刺激器联合超声引导与单独使用超声引导对腋路臂丛神经阻滞效果影响。方法 200例患者随机分为两组（n=100）U组）和神经刺激器联合超声组（NU组）。神经阻滞顺序均为桡神经、尺神经、正中神经和肌皮神经，每根神经使用0.5%罗哌卡因10ml进行阻滞。改变针尖位置，靠近神经束并注药，直至所有神经均被浸润。记录桡神经、尺神经、正中神经和肌皮神经阻滞的起效时间，并评价其阻滞成功率。结果 U组桡神经、尺神经感觉阻滞起效时间较NU组长（P0.05）。两组各神经阻滞成功率差异没有显著性，但在U组4根神经均阻滞成功率为93%，而NU组为100%，差异有显著性（P0.05）。结论 神经刺激器提高超声引导下的腋路臂丛阻滞成功率。 【关键词】 罗哌卡因；超声引导；神经刺激器；腋路臂丛 Nerve stimulator improved the success rate of ultrasound-guided approach in axillary brachial plexus block Zhang Da-zhi，Wang Geng, Wang Xiao-ling, Li Yu-jin, Zhang Wen-chao, Yang Xiao-yu.. Department of anesthesiology, Beijing Ji Shuitan hospital, Beijing 100035, China 【Abstract】　objective To compare efficacy of ultrasound –guided alone with nerve stimulator combined ultrasound –guided technique in axillary brachial plexus block. Methods　 patients were randomly allocated into two groups with 100 cases each, U group: ultrasound –guided alone and NU group: nerve stimulator combined ultrasound –guided. Nerve blocks were performed in the same order: radial, ulnar, median, and musculocutaneous, using 0.5% ropivacaine 10ml, respectively. Needle position was adjusted to provide circumferential spread of local anaesthetic around each nerve. The onset time of sensory blockade of radial, ulnar, median, and musculocutaneous nerves and the efficacy of block were recorded. Results The onset time of radial and ulnar nerves sensory blockade in the NU group was significantly shorter than that of in the U group（P0.05）. The success rate of sensory blockade of radial, ulnar, median, and musculocutaneous nerves in the NU group was not significant compared with U group. The success rate of brachial plexus block was 100% in NU group, which was higher than that of in U group (93%) significantly（P0.05）. Conclusion Nerve stimulator success rate of ultrasound-guided approach in axillary brachial plexus block. 【Key words】 ropivacaine, ultrasound machines , nerve stimulator, axillary brachial