超声引导联合神经刺激仪经肌间沟入路臂丛神经阻滞的临床疗效.docVIP

超声引导联合神经刺激仪经肌间沟入路臂丛神经阻滞的临床疗效 　　[摘要] 目的 观察在超声引导联合神经刺激仪经肌间沟入路行臂丛神经阻滞的效果分析。 方法 用前瞻性研究方法，将90例ASA为Ⅰ～Ⅱ级的上肢手术患者根据随机数字表法分为超声组（A组）、超声联合神经刺激仪组（B组）、传统组（C组），各组30例。对三组患者进行麻醉穿刺操作时间、痛觉阻滞效应、运动阻滞Bromage改良法、麻醉效果及不良反应评价。 结果 A组平均操作时间（4.7±0.9）min，B组为（3.5±0.7）min，A组与B组比较，差异有统计学意义（P0.05），C组与A组、B组各指标比较差异具有统计学意义（P0.01）;注药后15min、30min，A组和B组运动阻滞程度3级、4级、5级总例数明显多于C组，C组与A组、B组各指标比较，差异具有统计学意义（P0.05）;A组、B组麻醉优良率为100.00%，C组麻醉优良率73.33%，与A组、B组比较，差异具有高度统计学意义（P0.01）。 结论 超声引导联合神经刺激仪可以提高肌间沟臂丛阻滞的成功率，缩短神经痛觉阻滞起效时间、阻滞完善时间、麻醉操作时间，加快运动阻滞程度，提高了麻醉的安全性、有效性，值得临床推广应用。 　　[关键词] 超声引导;神经刺激仪;肌间沟;臂丛神经阻滞;上肢手术 　　[中图分类号] R614.3 [文献标识码] A [文章编号] 2095-0616（2015）02-16-04 　　The clinical efficacy of ultrasound-guided combined with nerve stimulator in the ditch by the muscles of the brachial plexus block 　　ZENG Junhua MA Dujun YU Tian 　　Department of Anesthesiology， Chinese Medical Hospital of Shenzhen， Shenzhen 518033， China 　　[Abstract] Objective To observe the effect analysis of ultrasound-guided joint nerve stimulator into the ditch by the muscles of the brachial plexus block. Methods With the method of prospective study， 90 patients with ASA gradeⅠ toⅡ treated by upper extremity surgery were allocated to the ultrasound group（A）， ultrasound combined with nerve stimulator（group B） and the traditional group（group C） based on the random number table method， 30 cases in each group. anesthetized puncture operating time， pain blocking effects， motor block Bromage modified method， the anesthetic effect and adverse comment among patients of the three groups were evaluated. Results The average operating time of group A was （4.7±0.9） min， that in group B was （3.5±0.7） min， group A compared with group B， the difference was statistically significant（P0.05）， the indexes between group C and group A， group C and group B had statistically significant differences（P 　　[Key words] Ultrasound guidance; Nerve stimulator; Interscalene; Brachial plexus; Upper extremity surgery 　　表1 三组患者基线情况比较 　　组别 n 性别 年龄（岁） 体重（kg） 手术部位 　　男 女 上臂 前部桡侧 前