国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
8期
692-694
,共3页
神经刺激器%喙突%臂丛%左旋布比卡因
神經刺激器%喙突%臂叢%左鏇佈比卡因
신경자격기%훼돌%비총%좌선포비잡인
Nerve stimulator%Coracoid%Brachial plexus%Levobupivacaine
目的 观察神经刺激器定位喙突下臂丛神经阻滞的临床效应. 方法 选择美国麻醉医师协会(ASA)分级Ⅰ～Ⅱ级,择期骨科上肢肘关节以下部位手术患者60例,按照随机数字表法分为喙突下组(A组)和腋路组(B组),每组30例.刺激器初始电流设置为1mA,频率2 Hz.A组在喙突下2 cm处,用神经刺激绝缘针垂直于皮肤进入,当电流减少至0.5 mA仍可见到正中、尺、桡神经三支神经支配区肌肉颤搐时,固定刺激针,回吸无血后各支注入0.5％左旋布比卡因10 ml.B组取腋动脉上方搏动最强处进针,诱发出无名指和小指颤搐反应,注入相同局麻药30 ml.记录两组的阻滞起效时间和维持时间；比较臂丛阻滞效果及感觉阻滞成功率；记录副作用；评价综合满意度. 结果 阻滞起效时间A组较B组短(P＜0.05)；维持时间两组间比较差异无统计学意义.A组桡、肌皮、腋、前臂内侧、臂内侧皮神经、正中神经感觉阻滞成功率为93.3％～100％,明显高于B组(60％～86.7％)(R＜0.05)；尺神经阻滞成功率均为100％.两组副作用的发生情况相似；综合满意度A组较B组高(P＜0.05).结论 神经刺激器定位喙突下臂丛阻滞方法操作简便,阻滞起效时间较短,阻滞成功率较高,可在临床上推广应用.
目的 觀察神經刺激器定位喙突下臂叢神經阻滯的臨床效應. 方法 選擇美國痳醉醫師協會(ASA)分級Ⅰ～Ⅱ級,擇期骨科上肢肘關節以下部位手術患者60例,按照隨機數字錶法分為喙突下組(A組)和腋路組(B組),每組30例.刺激器初始電流設置為1mA,頻率2 Hz.A組在喙突下2 cm處,用神經刺激絕緣針垂直于皮膚進入,噹電流減少至0.5 mA仍可見到正中、呎、橈神經三支神經支配區肌肉顫搐時,固定刺激針,迴吸無血後各支註入0.5％左鏇佈比卡因10 ml.B組取腋動脈上方搏動最彊處進針,誘髮齣無名指和小指顫搐反應,註入相同跼痳藥30 ml.記錄兩組的阻滯起效時間和維持時間；比較臂叢阻滯效果及感覺阻滯成功率；記錄副作用；評價綜閤滿意度. 結果 阻滯起效時間A組較B組短(P＜0.05)；維持時間兩組間比較差異無統計學意義.A組橈、肌皮、腋、前臂內側、臂內側皮神經、正中神經感覺阻滯成功率為93.3％～100％,明顯高于B組(60％～86.7％)(R＜0.05)；呎神經阻滯成功率均為100％.兩組副作用的髮生情況相似；綜閤滿意度A組較B組高(P＜0.05).結論 神經刺激器定位喙突下臂叢阻滯方法操作簡便,阻滯起效時間較短,阻滯成功率較高,可在臨床上推廣應用.
목적 관찰신경자격기정위훼돌하비총신경조체적림상효응. 방법 선택미국마취의사협회(ASA)분급Ⅰ～Ⅱ급,택기골과상지주관절이하부위수술환자60례,안조수궤수자표법분위훼돌하조(A조)화액로조(B조),매조30례.자격기초시전류설치위1mA,빈솔2 Hz.A조재훼돌하2 cm처,용신경자격절연침수직우피부진입,당전류감소지0.5 mA잉가견도정중、척、뇨신경삼지신경지배구기육전휵시,고정자격침,회흡무혈후각지주입0.5％좌선포비잡인10 ml.B조취액동맥상방박동최강처진침,유발출무명지화소지전휵반응,주입상동국마약30 ml.기록량조적조체기효시간화유지시간；비교비총조체효과급감각조체성공솔；기록부작용；평개종합만의도. 결과 조체기효시간A조교B조단(P＜0.05)；유지시간량조간비교차이무통계학의의.A조뇨、기피、액、전비내측、비내측피신경、정중신경감각조체성공솔위93.3％～100％,명현고우B조(60％～86.7％)(R＜0.05)；척신경조체성공솔균위100％.량조부작용적발생정황상사；종합만의도A조교B조고(P＜0.05).결론 신경자격기정위훼돌하비총조체방법조작간편,조체기효시간교단,조체성공솔교고,가재림상상추엄응용.
Objective To observe the clinical effect of subcoracoid brachial plexus block using nerve stimulator.Methods Sixty ASA physical status class Ⅰ-lⅡ patients scheduled for forearm surgery were randomized into two groups:subcoracoid group (group A) and axillary group (group B).The initial current of nerve stimulator was set to be 1 mA and the frequency was 2 Hz.In group A,0.5％ levobupivacaine 10 ml was injected respectively at the sites of muscle twitch induced by median,ulnar and radial nerve still can be seen when the current was lowered to 0.5 mA.In group B,same local anesthetics 30 ml was injected at the site of most intense pulse of axillary artery.The onset and anesthetic time were recorded.The success rate and degree of satisfaction were compared as well.Results The onset time of group A was shorter than that of group B (P＜0.05).There was no significant difference in anesthetic time between groups.The success rate in group A was 93.3％-100％,which was significantly higher than that of group B (P＜0.05).Side effect in both groups was similar.Degree of satisfaction in group A was higher than that in group B (P＜ 0.05).Conclusions Subcoracoid brachial plexus block using nerve stimulation technique is easy to perform,having shorter onset time and higher success rate.
