超声联合神经刺激仪臂丛神经干精准阻滞在肥胖患者上肢手术中的应用

目的 观察超声联合神经刺激仪臂丛神经干精准阻滞用于肥胖患者上肢手术中的麻醉效果。方法 选择2017年10月~2018年10月安徽医科大学附属巢湖医院收治的100例上肢手术肥胖患者为研究对象。根据随机数字表法分为超声联合神经刺激仪组（US-NS组）和超声组（US组），每组50例。US组采用超声引导下肌间沟臂丛神经阻滞，US-NS组采用超声联合神经刺激仪肌间沟臂丛神经阻滞。比较两组麻醉操作时间（T1）、阻滞完全时间（T2）、麻醉持续时间（T3）、麻醉效果分级、阻滞成功率及并发症发生率。结果 US-NS组阻滞成功率高于US组（98.00% vs 86.00%），差异有统计学意义（P＜0.05）；US-NS组T2短于US组[（7.70±1.54）min vs （10.30±1.39）min]，差异有统计学意义（P＜0.05）；US-NS组T3长于US组[（7.95±2.89）h vs（9.69±2.34）h]，差异有统计学意义（P＜0.05）；US-NS组T1长于US组[（7.43±1.36）min vs（5.30±1.44）min]，差异有统计学意义（P＜0.05）。结论 超声联合神经刺激仪用于肥胖患者臂丛神经阻滞成功率高，起效快。

Application of Ultrasound Combined with Neurostimulator for Brachial Plexus Nerve Block in Upper Limb Surgery in Obese Patients

Objective To observe the anesthetic effect of ultrasound combined with neurostimulator brachial plexus nerve block for upper limb surgery in obese patients.Methods 100 cases of obese patients with upper extremity surgery admitted to the Chaohu Hospital affiliated to Anhui Medical University from October 2017 to October 2018 were selected as subjects. According to the random number table method, it was divided into ultrasound combined with nerve stimulator group (US-NS group) and ultrasound group (US group), 50 cases in each group. The US group underwent ultrasound-guided intermuscular sulcus brachial plexus block, and the US-NS group underwent ultrasound combined with neurostimulator for intermuscular groove brachial plexus block. The anesthesia operation time (T1), complete block time (T2), duration of anesthesia (T3), anesthesia effect grading, block success rate, and complication rate were compared between the two groups.Results The success rate of US-NS group was higher than that of US group (98.00% vs 86.00%), the difference was statistically significant (P<0.05); US-NS group T2 was shorter than US group [(7.70±1.54) min vs (10.30) ±1.39)min], the difference was statistically significant (P<0.05); US-NS group T3 was longer than US group [(7.95±2.89)h vs (9.69±2.34)h], the difference was statistically significant (P<0.05) T1 was longer in the US-NS group than in the US group [(7.43±1.36) min vs (5.30±1.44) min],the difference was statistically significant (P<0.05).Conclusion Ultrasound combined with nerve stimulator is used for the brachial plexus block in obese patients with high success rate and fast onset.