中国医药导刊
中國醫藥導刊
중국의약도간
CHINESE JOURNAL OF MEDICAL GUIDE
2014年
6期
976-977
,共2页
神经刺激仪%臂丛阻滞麻醉%止血带反应%VAS评分
神經刺激儀%臂叢阻滯痳醉%止血帶反應%VAS評分
신경자격의%비총조체마취%지혈대반응%VAS평분
Neuro stimulator%Brachial plexus blocking anesthesia%Tourniquets' side effects%VAS score
目的：探讨在显微手外科手术中不同径路臂丛神经麻醉对术中上肢止血带反应效果的比较。方法：120例ASAⅠ~Ⅱ级手部显微手术患者,随机分为三组,采用神经刺激器辅助定位下三种不同径路臂丛神经阻滞,Ⅰ组单纯肌间沟法、Ⅱ组单纯腋路法和Ⅲ组肌间沟联合腋路法,使用药物为0.5%罗哌卡因30ml。每组止血带控制压力为270mmHg,手术每1h放松10min后再充气继续手术。观察并记录麻醉起效时间、麻醉效果、臂丛并发症、止血带反应的发生例数及止血带充气满1h放气前患者的VAS评分。结果：Ⅲ组感觉、运动阻滞起效时间明显短于Ⅰ组、Ⅱ组,明显缩短了手术等待时间(P<0.05)。Ⅲ组麻醉效果优良率达100%,术中无止血带疼痛反应发生,100%患者VAS评分≤3。结论：肌间沟联合腋路臂丛神经阻滞麻醉在复杂显微手外科手术时,麻醉效果安全可靠,镇痛效果良好,有效预防止血带反应。
目的：探討在顯微手外科手術中不同徑路臂叢神經痳醉對術中上肢止血帶反應效果的比較。方法：120例ASAⅠ~Ⅱ級手部顯微手術患者,隨機分為三組,採用神經刺激器輔助定位下三種不同徑路臂叢神經阻滯,Ⅰ組單純肌間溝法、Ⅱ組單純腋路法和Ⅲ組肌間溝聯閤腋路法,使用藥物為0.5%囉哌卡因30ml。每組止血帶控製壓力為270mmHg,手術每1h放鬆10min後再充氣繼續手術。觀察併記錄痳醉起效時間、痳醉效果、臂叢併髮癥、止血帶反應的髮生例數及止血帶充氣滿1h放氣前患者的VAS評分。結果：Ⅲ組感覺、運動阻滯起效時間明顯短于Ⅰ組、Ⅱ組,明顯縮短瞭手術等待時間(P<0.05)。Ⅲ組痳醉效果優良率達100%,術中無止血帶疼痛反應髮生,100%患者VAS評分≤3。結論：肌間溝聯閤腋路臂叢神經阻滯痳醉在複雜顯微手外科手術時,痳醉效果安全可靠,鎮痛效果良好,有效預防止血帶反應。
목적：탐토재현미수외과수술중불동경로비총신경마취대술중상지지혈대반응효과적비교。방법：120례ASAⅠ~Ⅱ급수부현미수술환자,수궤분위삼조,채용신경자격기보조정위하삼충불동경로비총신경조체,Ⅰ조단순기간구법、Ⅱ조단순액로법화Ⅲ조기간구연합액로법,사용약물위0.5%라고잡인30ml。매조지혈대공제압력위270mmHg,수술매1h방송10min후재충기계속수술。관찰병기록마취기효시간、마취효과、비총병발증、지혈대반응적발생례수급지혈대충기만1h방기전환자적VAS평분。결과：Ⅲ조감각、운동조체기효시간명현단우Ⅰ조、Ⅱ조,명현축단료수술등대시간(P<0.05)。Ⅲ조마취효과우량솔체100%,술중무지혈대동통반응발생,100%환자VAS평분≤3。결론：기간구연합액로비총신경조체마취재복잡현미수외과수술시,마취효과안전가고,진통효과량호,유효예방지혈대반응。
To investigate the effects of using different pathways in branchial plexus blocking anesthesia on tourniquets' side effects during surgeries.Methods:120 ASAⅠ~Ⅱpatients were randomly divided into 3 groups with 40 cases each. neuro stimulator were used to help position their lower brachial plexus nerve blocking with the use of 30ml 0.5%ropivacaine.Interscalene for groupⅠ,axillar for groupⅡ,and both interscalene and axillar for groupⅢ.All groups used 270mmHg as the tourniquet's control pressure.Every hour during surgeries,the tourniquet was inflated again after the pressure was released for 10 minutes.The starting time of the anesthesia,the effects of the anesthesia,the complication of brachial plexus,the number of tourniquet side effects,and VAS score of the patients right before the pressure of the tourniquet was released were recorded.Results:The starting time of motion blocking of groupⅢis much shorter than that of groupⅠand groupⅡand therefore the waiting time during surgeries is significantly reduced (P<0.05).The successful rate of groupⅢis 100%with no painful side effects caused by tourniquets during surgeries.Conclusion:Interscalene and axillar as pathways in branchial plexus blocking anesthesia is a safe technique in its analgesic and sedative effects,and it can also effectively prevent the negative side effects caused by tourniquets.
