English Lorraine A, Holmes Johnnie M, Burkard Joseph F, Vacchiano Charles A, Shin Alexander, Pellegrini Joseph, Maye John P
United States Naval Hospital, Okinawa, Japan.
AANA J. 2004 Feb;72(1):57-60.
The transarterial approach to brachial plexus block is a well-established method of producing anesthesia of the upper extremity. However, it is associated with a failure rate of 20% to 30%. Failure may be secondary to the common use of a relatively long needle, which can penetrate the posterior wall of the sheath and result in inadvertent injection of the local anesthetic into the surrounding tissue. The purpose of this investigation was to compare success rates following transarterial brachial plexus block with a standard 22-gauge, 1 1/2-in, B bevel needle or a 26-gauge, 1/2-in needle. We enrolled 98 subjects scheduled for elective surgery at or below the elbow and randomized them into 2 groups. The control group received a transarterial axillary block with a standard 22-gauge, 1 1/2-in, B bevel needle, and the experimental group received a transarterial axillary block with a 26-gauge, 1/2-in needle. Success was defined as no discomfort at the time of incision. Success rates were compared using a chi 2 test, and a P value of less than .05 was considered significant. The overall success rate was significantly higher with the 26-gauge, 1/2-in needle (42/48 [88%]) than with the 22-gauge, 1 1/2-in needle (39/49 [69%]; P = .035).
经动脉途径进行臂丛神经阻滞是一种成熟的上肢麻醉方法。然而，其失败率为20%至30%。失败可能继发于常用的相对较长的穿刺针，这种针可能穿透鞘的后壁，导致局部麻醉药意外注入周围组织。本研究的目的是比较使用标准的22号、1.5英寸、B型斜面针或26号、0.5英寸针行经动脉臂丛神经阻滞后的成功率。我们纳入了98例计划在肘部或肘部以下进行择期手术的受试者，并将他们随机分为两组。对照组使用标准的22号、1.5英寸、B型斜面针行经动脉腋路阻滞，实验组使用26号、0.5英寸针行经动脉腋路阻滞。成功定义为切开时无不适。使用卡方检验比较成功率，P值小于0.05被认为具有统计学意义。使用26号、0.5英寸针的总体成功率（42/48 [88%]）显著高于使用22号、1.5英寸针的成功率（39/49 [69%]；P = 0.035）。
