[1]曲彦亮,申恒花,温宝磊,等.双侧腋路臂丛神经阻滞用于双上肢显微外科术中的探索研究[J].第三军医大学学报,2016,38(22):2457-2461.
 Qu Yanliang,Shen Henghua,Wen Baolei,et al.Anesthetic efficacy and safety of bilateral axillary brachial plexus block in microsurgery for bilateral upper limbs[J].J Third Mil Med Univ,2016,38(22):2457-2461.
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双侧腋路臂丛神经阻滞用于双上肢显微外科术中的探索研究(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
38卷
期数:
2016年第22期
页码:
2457-2461
栏目:
临床医学
出版日期:
2016-11-30

文章信息/Info

Title:
Anesthetic efficacy and safety of bilateral axillary brachial plexus block in microsurgery for bilateral upper limbs
作者:
曲彦亮申恒花温宝磊武春敏张立新王德明张元信侯书健张欣马超刘春燕
解放军第401医院全军手外科中心; 青岛市第八人民医院麻醉科
Author(s):
Qu Yanliang Shen Henghua Wen Baolei Wu Chunmin Zhang Lixin Wang Deming Zhang Yuanxin Hou Shujian Zhang Xin Ma Chao Liu Chunyan

Center for Hand Surgery, No. 401 Hospital of PLA, Qingdao, Shandong Province, 266071; Department of Anesthesiology,Qingdao Eighth People’s Hospital, Qingdao, Shandong Province, 266071, China

关键词:
双侧腋路臂丛神经阻滞全身麻醉双上肢显微外科手术
Keywords:
bilateral axillary branchial plexus block general anesthesia bilateral upper limb microsurgery
分类号:
R614.4;R616.2;R658.2
文献标志码:
A
摘要:

目的     探索研究双侧腋路臂丛神经阻滞用于双上肢显微外科术中的麻醉效果及安全性。方法      双上肢显微外科手术患者80例,ASA分级Ⅰ~Ⅱ级,采用随机数字表达分为两组,每组40例,臂丛组在神经刺激仪下行双侧腋路臂丛神经阻滞,全麻组采用气管插管静吸复合全身麻醉。比较两组患者麻醉前(T1)、麻醉完成时(T2),手术开始时(T3)、手术结束时(T4)的生命体征;术后2、4、8、12 h疼痛程度;术后疼痛感知时间,麻醉费用,不良反应以及术者和患者麻醉满意度。结果     血压、心率全麻组内T1时明显低于T4时(P<0.05),组间T4时臂丛组明显低于全麻组(P<0.05);术后2、4、8 h疼痛VAS评分臂丛组明显低于全麻组(P<0.05);术后疼痛感知时间臂丛组明显长于全麻组(P<0.05),麻醉费用臂丛组明显低于全麻组(P<0.05),不良反应发生率臂丛组明显低于全麻组(P<0.05);术者和患者的麻醉满意度臂丛组明显高于全麻组(P<0.05)。结论     双侧腋路臂丛神经阻滞适合双上肢显微外科手术。

Abstract:

Objective      To observe the clinical effects and safety of bilateral axillary brachial plexus block in microsurgery for bilateral upper limbs. Methods      In this randomized controlled trial, 80 patients classified to ASA grade Ⅰ or Ⅱ physical status were randomly allocated to 2 groups, i.e., general anesthesia and bilateral brachial plexus block, for upper limb microsurgery. Each group contained 40 patients. In brachial plexus group, bilateral axillary brachial plexus block was carried out under the instruction of Nerve Stimulator, while Intravenous-inhalation Combined Anesthesia was used in general anesthesia group. Vital signs were assessed before anesthesia (T1) and after anesthesia (T2), as well as before surgery (T3) and after surgery (T4). Pain status was scored at 2, 4, 8 and 12 h after surgery. Adverse events as well as satisfaction in anesthesia and anesthesia fees were assessed. Results     In general anesthesia group, systolic pressure (BP) and heart rate (HR) were significantly lower at T1 versus at T4 (P<0.05). At T4, they were significantly higher than brachial plexus group (P<0.05). The VAS score of postoperative 2, 4 and 8 h showed that patients in general anesthesia suffered more pain compared to patients in brachial plexus group (P<0.05). However, the postoperative pain period was significantly longer in brachial plexus group than in general anesthesia group (P<0.05). In addition, the cost of general anesthesia was significantly higher compared to brachial plexus group, associated with higher incidence of adverse events but less patient satisfaction (P<0.05). Conclusion      Bilateral axillary brachial plexus block is suitable under the operation of bilateral upper limb microsurgery.

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更新日期/Last Update: 2016-11-23