高位肌间沟一点三向阻滞法在锁骨及肩关节手术中的应用

摘要

Objective To observe the clinical anaesthetic effect of the higher intermuscular groove nerve blockage one point three direction needle-inserting method in clavicle or shoulder joint operation. Methods Sixty ASA I or II patients undergoing unilateral clavicle or shoulder joint operation were randomly divided into two groups, the higher intermuscular groove nerve blockage one point three direction needle-inserting method ( Group A )and the higher intermuscular brachiel blockage ( Group B ). Anesthesia results in the two groups were compared BP,HR and VAS were estimated at the time span of preoperative( T0 ),skin incision( T1 ),bone operation( T2 )and skin sutu-ring( T1 ),and adverse reactions and complications were recorded. Results The anesthesia results of group A was better than that of group B( P <0. 05 ). VAS of group A was lower than that of group B at the time span of T1,T2 ,T3( P <0. 05 ). BP of group B was higher than that of group A at the time span of T2. There is no statistical significance in adverse reactions. Conclusion The higher intermuscular groove nerve blockage one point three direction needle-in-serting method has higher success rate and more effective anaesthesia.%目的 观察高位肌间沟一点三向阻滞法在锁骨及肩关节手术中的麻醉效果.方法 60例ASA I～Ⅱ级需行一侧锁骨或肩关节处手术的病人随机分为两组;经高位肌间沟一点三向阻滞组(A组)和传统高位肌间沟臂丛阻滞组(B组).比较两组患者的麻醉效果,观察两组患者术前(T0)、切皮(T1)、骨性操作(T2)和缝皮(T3)4个时间点的无创血压(BP)、心率(HR)和VAS评分,记录不良反应及并发症.结果 A组麻醉效果优于B组,A组T1、T2、T3时间点VAS评分明显低于B组(P<0.05);B组T2时间点血压明显高于A组(P<0.05).两组不良反应比较差异无统计学意义.结论 高位肌间沟一点三向阻滞法,阻滞成功率高,麻醉效果好.