反向斜引进针行肌间沟臂丛神经阻滞的疗效观察

目的观察反向斜引进针法行肌间沟臂丛神经阻滞在肩部及上臂手术中的麻醉效果和安全性。方法90例肩部和上臂手术的患者，随机分为A、B两组，A组采用反向斜引进针阻滞法，B组采用传统的肌间沟阻滞法。观察比较两组的一次穿刺成功率、麻醉显效时间、麻醉起效时间、麻醉维持时间、运动阻滞起效时间及麻醉效果和有无并发症。结果A组的麻醉显效及起效时间明显短于B组（P〈0．05），A组的运动阻滞起效时间明显长于B组（P〈0．05），麻醉效果及一次穿刺成功率明显优于和高于B组，效果确切、安全、无并发症。结论反向斜引进针法行肌间沟臂丛神经阻滞操作简便，较传统肌间沟臂丛神经阻滞法麻醉起效时间快，麻醉效果也更加确切，并发症少，并且有区域阻滞选择性，值得临床推广和应用。

The effectiveness of reversely and obliquitously puncturing interscalene brachial plexus block

Objective To observe the validity and safety of reversely and obliquitously puncturing interscalene braehial plexus block in shoulder and upper arm surgeries. Methods Ninety patients under shoulder and upper arm surgeries were randomly divided into two groups： group A and group B. Group A received reversely and obliquitously punctu- ring interscalene brachial plexus block while Group B received traditional approach of interscalene brachial plexus block. The first puncture achievement ratio, anesthesia induction time, the onset time and maintenance time of algesthesia blocking,the onset time of motor blocking, the quality of blockade and post operative complications were recorded. Results The onset time of sensory blocking of group A was shorter than that of group B （P〈0.05）. The onset time of motor blocking of group A was longer than that of group B （ P〈0.05 ）. The first puncture achievement ratio and the bloeking effect of group A were also better than group B. There were no post-operation eomplicaptions in group A. Conclusion Compared with traditional method, interscalene braehial plexus block under reversely and obliquitously puncture was safer and showed higher blocking effect. It is an innovative and convenient method to provide suitable surgery condition.