标题：超声引导下肌间沟入路臂丛神经阻滞麻醉效果观察

      作者：申治国，薛建军，贺隶国，田建波，徐小想
    （深圳市宝安区松岗人民医院麻醉科，广东 深圳 518105）

      卷次： 2016年27卷13期

      【摘要】 目的 观察超声引导下肌间沟入路臂丛神经阻滞的麻醉效果。方法 选择2014年5月至2016年3月期
间ASA Ι~Ⅱ级、体格正常、18~55岁男性，拟行单侧上肢手部手术患者100例。在超声引导下行肌间沟臂丛神经阻滞，
观察记录注药前的超声解剖图像、注药前臂丛神经上、中、下干下缘到皮肤的距离；观察记录操作用时、麻醉阻滞效果
及不良反应发生率。结果 各神经干下缘到皮肤的距离（平均值）：上干 1.002 cm (100例)，中干 1.598 cm (100例)，下
干2.26 cm (45例)。操作平均用时为3 min 56 s；92%的操作用时在 3~5 min内。麻醉效果中优 81 %，良 11 %，差
6 %，无效 2 %，有效率为92%；不良反应有霍纳征 3例、注药后寒颤 1例、术中恶心、呕吐 1例。结论 超声引导下肌间
沟入路臂丛神经阻滞适用于单侧上肢手部桡侧手术，对于涉及到上肢手部尺侧的手术，在安全范围内，应用较大剂
量（浓度）的局麻药和（或）追加尺神经阻滞是有必要的。

      【关键词】 超声引导；肌间沟入路；臂丛神经阻滞；麻醉效果

      【中图分类号】 R614.4 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2147—03


Clinical observation on anesthetic effect of ultrasound-guided interscalene brachial plexus block.
SHEN Zhi-guo,
XUE Jian-jun, HE Li-guo, TIAN Jian-bo, XU Xiao-xiang. Department of Anesthesia, Baoan District Songgang People's
Hospital, Shenzhen 518105, Guangdong, CHINA

【Abstract】 Objective To observe anesthetic effect of ultrasound-guided interscalene brachial plexus block.
Methods One hundred male ASA classⅠ orⅡ patients with aged 18~55 years old undergoing upper limb operation in
our hospital during May 2014 to March 2016 March. Ultrasound guided interscalene brachial plexus block was per-
formed for all the patients. The ultrasound anatomical image before and after the injection and the neural stem distance
(superior, middle and interior) to the skin were observed. The operating time, the effect of anesthesia, the incidence of ad-
verse reactions were recorded. Results Each lower edge of neural stem distance to the skin (average): superior was
1.002 cm (n=100), middle was 1.598 cm (n=100), interior was 2.26 cm (n=45); Average operating time was 3 minutes
and 56 seconds, with 92% (92/100) within 3 to 5 minutes. Anesthetic effect: excellent 81% (81/100), good 11% (11/100),
poor 6% (6/100), invalid 2% (2/100), effective rate 92%. Adverse reaction statistics: three cases of Horner syndrome,
one case of chills after injection, one case of intraoperative nausea and vomiting. Conclusion Local ultrasound-guided
interscalene brachial plexus block approach provides excellent block with fewer adverse reactions in the radial side of up-
per limb surgery. In the upper extremity ulnar surgery, using a larger dose of local anesthetic and (or) extra local anesthe-
sia and the ulnar nerve lock are necessary in the context of security.

      【Key words】 Ultrasound guided; Interscalene approach; Brachial plexus block; Anesthetic effect
·论 著·
6350.2016.13.029