超声引导锁骨上入路臂丛神经阻滞与腋窝入路在小儿上肢手术中的应用对比

摘要

Objective:To compare the clinical application of ultrasound guided supraclavicular brachial plexus block and ultrasound -guided axillary brachial plexus block in children with upper extremity surgery .Methods:Fifty ASA class I orⅡchildren at Shantou Cen-tral Hospital from November 2012 to February 2014 ,approved by hospital ethics committee scheduled for upper extremity surgery were ran -domized to ultrasound guided supraclavicular brachial plexus block ( group A ) and ultrasound -guided axillary brachial plexus block ( group B) according to numeration table .The onset time and duration of sensory blockade were recorded .The anesthetic effect of surgical field ( rated as excellent ,good and failure ) were both assessed .The complications were observed and recorded as well .Results: There wan no significant difference in the onset time , the duration time , the block -related complications and the anesthesia effect between group A and group B .Conclusion:ultrasound guided supraclavicular brachial plexus block and ultrasound-guided axillary brachial plex-us block in children with upper extremity surgery were both safe and valid .%目的：比较超声引导下臂丛神经阻滞锁骨上入路与腋窝入路在小儿上肢手术中应用，寻找一种更理想的阻滞入路。方法：我院2012年11月～2014年2月择期行上肢手术的小儿患者50例，ASA I～II，男女不限，年龄5～14岁，通过医院伦理道德委员会批准，所有患儿家属均签署麻醉知情同意书，应用数字表法随机分成2组：A组行超声引导下锁骨上入路臂丛神经阻滞。B组行超声引导下腋窝入路臂丛神经阻滞。记录感觉阻滞起效时间、持续时间、麻醉效果、并发症发生情况等。结果：A组感觉阻滞起效时间与B组比较，差异无统计学意义（P＞0．05）， A组感觉阻滞持续时间与B组比较，差异无统计学意义（P＞0．05），A组阻滞优良率与B组比较，差异无统计学意义（P＞0．05），A组并发症发生率与B组比较，差异无统计学意义（P＞0．05）。结论：无论超声引导下锁骨上入路臂丛神经阻滞还是腋窝入路，在小儿上肢手术中均安全有效。