目的 探讨腋路远端臂丛神经阻滞的方法和效果.方法 患者上肢外展80度,在上肢的中上1/3交界处触及肱动脉搏动,连续阻滞四支终末神经,多点注射,麻醉起效后,观察并记录感觉和运动阻滞完善时间、镇痛效果、麻醉持续时间和并发症发生情况.结果 56例患者感觉阻滞完善时间为(9.06+3.57)分钟,运动阻滞完善时间为(14.9+4.5)分钟,镇痛持续时间(268.1+31.2)分钟,均未发生蛛网膜下腔或硬膜外阻滞、喉返神经或膈神经阻滞、霍纳综合征、气胸、局麻药中毒等并发症,血流动力学及呼吸平稳.结论 腋路远端臂丛神经阻滞麻醉操作简单安全,易掌握,并发症少,阻滞效果较完善,适合饱胃、急危重症及肥胖患者肘部以下手术.%Objective To assess the method and efficacy of axillary brachial plexus blockage in hand surgery. Methods The patients upper extremity was abducted to 80 degree. When the pulses of arterial brachial were touched at the upper 1/3 of the upper extremity, local anesthetic was used in multipoint injection to keep blocking four terminal nerves. After the effect of anesthetic is obtained , we observed and recorded the achievement times of sensory and motor block, analgesia effect, duration of anaesthesia and incidence rate of complications. Results Sensory block achievement time, motor block achievement time and analgesia duration were (9. 06 ±3. 57) mns, (14. 9 ±4. 5) inns and (268. 1 ±31. 2) mns respectively. No epidural block, subarachnoid block, recurrent laryngeal nerve block, phrenic nerve block, Horner syndrome, pneumothorax, recurrent nerve or local anesthetic poisoning occurred in our study Haemodynamics and respiratory were stable. Conclusion Axillary brachial plexus blockage is a good, easy and safe method, with fewer complications, complete blocking effect, which is suitable for surgeries below the elbow, especially for obese patients who is intensively ill and with full stomach.
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