神经刺激仪经肌间沟定位臂丛神经分支行臂丛麻醉效果分析

目的：比较神经刺激仪经肌间沟定位臂丛神经分支行肌间沟臂丛神经阻滞麻醉的效果及安全性。方法：选择拟行肌间沟臂丛神经阻滞的上肢手术的患者80例，ASAI或II级，随机均分为A组和B组，每组40例患者。两组均给予1％的利多卡因＋0．375％耐乐品20mL。记录完成操作所需时间、感觉神经阻滞起效时间、感觉神经阻滞完善时间、运动神经阻滞起效时间、运动神经阻滞完善时间；评价手术区域麻醉效果（优、良、差、失败）；观察并记录并发症。结果：A组完成操作所需时间（5．01±1．40）min，明显长于B组（2．83＋O．87）min（P〈0．01）。A组感觉阻滞起效时间（4．48±1．36）min，明显短于B组（7．0±2．06）min（P〈0．01）；A组运动阻滞起效时间（4．88＋±1．18）min，明显短于B组（7．0±1．67）min（P〈0．01）。A组感觉阻滞完善时间（11．73±3．62）短于B组（13．33±3．02）min（P=0．033）。A组运动阻滞完善时间（11．18±2．73）短于B组（12．41±2．48）min（P=0．038）；麻醉效果优等率A组为87．5％，B组为67．5％，差异有统计学意义x^2=4．588，P=0．032；优良率A组为97．5％，B组为90．0％，差异无统计学意义x2=1．920，P=0．166；A组、B组均未出现严重麻醉并发症。结论：A组行肌间沟臂丛神经阻滞比B组阻滞操作时间长，但神经阻滞麻醉效果好，神经阻滞完善率高。

A Comparative Study of Interscalene Brachial Plexus Block by Nerve Stimulator Locating Different Brachial Plexus Branches

Objective： To compare the effects and safety of positioning way with neurostinulator on brachial plexus block. Methods： Eighty patients operated the upper limb were randomized into two groups （ n = 40 each ）： Group A was guided by neurostinulator through locating radial nerve, median nerve, ulnar nerve; In group B, nerve stimulator was used to loccate musculocutaneous nerve. The two groups were given 1% lidocaine ＋0.375% Naropin 20 mL. Record time searching for a target neural and completing the operation, the onset of sensory nerve block and motor nerve block were measured; Record time that sensory nerve and motor nerve were blocked completedly and analgesia was rated as excellent, effective, poor and failure. Results： Group A completed the operation need the time （ 5.01 ±1.40） min was significantly longer than the B group （ 2.83 ±0.87） rain （ P〈0.01 ）. Sensory block onset time of group A （ 4.48±1.36 ） min, was significantly shorter than the group B （ 7 ±2.06） min （ P〈0.01 ）; group A motion block onset time （ 4.88±1.18 ） min was significantly shorter than that in the group B （ 7 ±1.67） min （ P〈0.01 ）. Group A feel complete block time （ 11.73±3.62 ） is shorter than the group B （ 13.33±3.02 ） min （ P=0.033 ）.The time that motion nerve was blocked completedly in the group A （ 11.18±2.73 ） is shorter than the group B （ 12.41±2.48 ） rain （ P=0.038 ）; anesthetic effect excellent rate was 87.5% in the group A, was 67.5% in the group B, there were statistically significant differences between A and B （x^2=4.588, P=0.032）; excellent and good rate of the group A was 97.5%, 90% in the group B, the difference was not statistically meaning in the two group （x^2=-1.920, P=0.166）; Both two group had no severe complication of anesthesia. Conclusions： Group A is better than group B, it gets shorter onset time and more efficiency ,but the operation time of the group A is more longer than the group B.