CAJ | 학술논문

背景肌间沟臂丛神经阻滞(interscalene brachial plexus block,ISBPB)是肩锁关节及上肢手术一种良好的麻醉和镇痛方法,但是麻醉医师常常关注其即时并发症(如局部麻醉药中毒),对于其延迟或远期并发症关注较少(比如ISBPB引起的膈肌麻痹). 目的回顾国内外关于ISBPB后膈肌麻痹发生率的研究,为ISBPB所需的局部麻醉药的最佳剂量提供参考. 内容阐述ISBPB引起膈肌麻痹的危害、发生原因、影响因素以及诊断、预防和治疗. 趋向在超声联合神经刺激仪的精确定位下,尽早将0.375％罗哌卡因5ml～10 ml运用于ISBPB可获得满意的麻醉和术后镇痛效果,并且膈肌麻痹发生率较低.
배경 기간구비총신경조체(interscalene brachial plexus block,ISBPB)시견쇄관절급상지수술일충량호적마취화진통방법,단시마취의사상상관주기즉시병발증(여국부마취약중독),대우기연지혹원기병발증관주교소(비여ISBPB인기적격기마비). 목적 회고국내외관우ISBPB후격기마비발생솔적연구,위ISBPB소수적국부마취약적최가제량제공삼고. 내용 천술ISBPB인기격기마비적위해、발생원인、영향인소이급진단、예방화치료. 추향 재초성연합신경자격의적정학정위하,진조장0.375％라고잡인5ml～10 ml운용우ISBPB가획득만의적마취화술후진통효과,병차격기마비발생솔교저.
Background Interscalene brachial plexus block (ISBPB) is regarded as an effective method of anesthesia and analgesia for shoulder and upper extremity surgery.Anesthesiologists always focus on its immediate complications such as local anesthetics poisoning,but they pay less attention for its delay or long-term complications,such as phrenic nerve paralysis after ISBPB.Objective Reviewing domestic and foreign research on diaphragm paralysis incidence after ISBPB and providing the optimal reference dosage of local anesthetics for ISBPB.Content Elaborating cause,harmfulness,influence factors,diagnosis,prevention and treatment of diaphragm paralysis after ISBPB.Trend Under the accurate positioning of ultrasound combined with nerve stimulator,applying 0.375％ ropivacaine 5 ml to 10 ml in ISBPB as soon as possible can result in a satisfactory anesthesia and postoperative analgesia effect and lower incidence of diaphragm paralysis.