CAJ | 학술논문

目的探讨改良喙突入路和经典喙突入路定位对锁骨下臂丛神经阻滞的影响.方法对60例择期行臂丛神经阻滞手术的患者,按随机数字表法分为观察组(采用神经刺激器定位臂丛神经)和对照组,每组30例.对照组以喙突内下2 cm为穿刺点,观察组穿刺点参考喙突内下2 cm,并用臂丛神经体表的投影对该穿刺点进行改良.记录两组操作时间、穿刺次数、阻滞成功率、并发症及患者的24 h麻醉满意度.结果观察组操作时间明显少于对照组[(3.2±1.1) min比(4.3±1.4)min] (P＜ 0.05),且观察组一次穿刺定位到神经的比率明显高于对照组[73.3％(22/30)比50.0％(15/30)](P＜ 0.05).两组阻滞成功率、并发症及患者的24 h麻醉满意度比较差异无统计学意义(P＞0.05).结论改良喙突入路可以明显提高单次穿刺定位到神经的概率,且可减少操作时间,提高了穿刺点体表定位的准确性.
목적 탐토개량훼돌입로화경전훼돌입로정위대쇄골하비총신경조체적영향.방법 대60례택기행비총신경조체수술적환자,안수궤수자표법분위관찰조(채용신경자격기정위비총신경)화대조조,매조30례.대조조이훼돌내하2 cm위천자점,관찰조천자점삼고훼돌내하2 cm,병용비총신경체표적투영대해천자점진행개량.기록량조조작시간、천자차수、조체성공솔、병발증급환자적24 h마취만의도.결과 관찰조조작시간명현소우대조조[(3.2±1.1) min비(4.3±1.4)min] (P＜ 0.05),차관찰조일차천자정위도신경적비솔명현고우대조조[73.3％(22/30)비50.0％(15/30)](P＜ 0.05).량조조체성공솔、병발증급환자적24 h마취만의도비교차이무통계학의의(P＞0.05).결론 개량훼돌입로가이명현제고단차천자정위도신경적개솔,차가감소조작시간,제고료천자점체표정위적준학성.
Objective To investigate the effects between the modified and classic coracoid approach in infraclavicular brachial plexus nerve block.Methods Sixty patients scheduled for elective surgical procedures under infraclavicular brachial plexus block were divided into observation group and control group by table of random digit method with 30 cases each.The puncture point of control group was approach via the point 2 cm medial and caudal to the coracoid process.The puncture point of observation group was modified by surface projection of the brachial plexus.Peripheral nerve stimulator was used to confirm the proper localization of the plexus.The performance time,number of puncture,anesthesia success rate,incidence of complications and 24 h patient satisfaction were recorded.Results The performance time in observation group was less than that in control group [(3.2 ± 1.1) min vs.(4.3 ± 1.4) min](P＜ 0.05).The chance of locating the brachial plexus in a single puncture without adjusting the block needle in observation group was significantly higher than that in control group [73.3％ (22/30) vs.50.0％ (15/30)] (P ＜ 0.05).There were no statistical differences in anesthesia success rate,incidence of complications and 24 h patient satisfaction between two groups (P ＞ 0.05).Conclusions The modified coracoid approach can significantly improve the probability of locating the nerve in one puncture that reduces the performance time.It can improve the accuracy of puncture point position on the body surface.