河北医科大学学报

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神经刺激仪引导喙突旁入路双点注射臂丛神经阻滞的临床研究

  

  1. .河北省秦皇岛市第一医院麻醉科,河北 秦皇岛 066000;2.河北省秦皇岛市妇幼保健院计划生育科,河北 秦皇岛 066000
  • 出版日期:2019-02-25 发布日期:2019-01-16
  • 作者简介:何文胜(1986-),男,湖北黄冈人,河北省秦皇岛市第一医院主治医师,医学硕士,从事临床麻醉学研究。

Effect of dualinjection on coracoid approach brachial plexus block guided by nerve stimulator:compared with singleinjection 

  1. 1.Department of Anesthesiology, the First Hospital of Qinhuangdao, Hebei Province, Qinhuangdao
    066000, China; 2.Department of Family Planning, Maternal and child Health Care Hospital of
    Qinhuangdao, Hebei Province, Qinhuangdao 066000, China
  • Online:2019-02-25 Published:2019-01-16

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗观察喙突旁入路双点注射臂丛神经阻滞在上肢手术中的效果。
〖HTH〗方法〖HTSS〗〖KG*2〗选择美国麻醉医师协会Ⅰ~Ⅱ级拟行上肢肘关节及其远端部位手术的患者80例,随机分为双点注射组(D组)和单点注射组(S组),每组40例。采用神经刺激仪引导,实施喙突旁入路臂丛神经阻滞。S组诱发出目标肌肉运动后注射0.375%罗哌卡因40 mL;D组需要诱发出2次不同的肌肉运动,每次注射0.375%罗哌卡因20 mL。 注射药物完毕后每隔5 min测试臂丛在前臂终末神经的感觉和运动阻滞情况,并记录操作时间、成功率和并发症发生情况。
〖HTH〗结果〖HTSS〗〖KG*2〗D组总体感觉和总体运动阻滞起效时间短于S组(P<005),D组尺神经和桡神经感觉阻滞起效时间短于S组(P<005),D组桡神经运动阻滞起效时间短于S组(P<005)。D组阻滞成功率高于S组(P<005)。D组操作时间长于S组(P<005)。2组均无明显并发症发生。
〖HTH〗结论〖HTSS〗〖KG*2〗双点注射能缩短喙突旁入路臂丛神经阻滞的感觉和运作阻滞起效时间,提高阻滞效果,不增加并发症发生率;但是需要更长的操作时间。

关键词: 神经传导阻滞, 臂丛, 喙突, 双点注射

Abstract: [Abstract]〓Objective〖HTSS〗〓To observe the effect of dualinjection on coracoid approach brachial plexus block guided by nerve stimulator for upper extremity surgery.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Eighty patients ASA classⅠ-Ⅱscheduled for surgery in elbow,forearm,wrist or hand were randomly divided into two group: dualinjection group(group D) and singleinjection group(group S), 40 patients in each group. All cases were received coracoid approach brachial plexus block guided by nerve stimulator. 40 mL 0.375% ropivacaine was injected after evoking one target muscle movement in group S. While two different muscle movements need to be evoke in group D. Sensory block and motor block was evaluated every 5 minutes after injection of the local anesthetic. The time required to complete the block, success rate and complications were also tanked notes.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The sensory block and motor block onset time in group D was significantly shorter than that in group S(P<005) . The sensory block onset time for ulnar nerve and radial nerve in group D was significantly shorter than that in group S(P<005). The motor block onset time for radial nerve in group D were significantly shorter than that in group S(P<005). The success rate in group D was significantly higher than that in group S(P<005) . The time required to complete the block in group D was longer than that in group S(P<005). No significant complications occurred in the two groups.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Dualinjection technique can shorten sensory block and motor block onset time and increase block effect without increasing the complications for coracoid approach brachial plexus block. But it requires longer time to complete the block.

Key words: nerve block;brachial plexus; coracoid, dualinjection