Shen J T, Ho S T, Hwang S J, Chung H C
Department of Anesthesiology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan, R.O.C.
Ma Zui Xue Za Zhi. 1992 Jun;30(2):107-11.
We examined results of brachial plexus block in 31 young male patients who underwent upper extremity surgical procedures. Interscalene block was performed using a paresthesia technique in 13 patients and axillary block, using the perivascular technique, in 18 patients. In both groups, 30 ml 1.5% lidocaine with 1:200,000 epinephrine was injected. Sensory blockade was evaluated at 5 min and 15 min after injection, determined by pinprick. Results showed that the interscalene technique preferentially blocked the cephalad nerves while the axillary technique produced similar block of both cephalad and caudal nerves of the brachial plexus. Difference between groups was statistically significant, suggesting that the extent of nerve block depends on the technique of approach per se. The difference in patterns of nerve blocked by either technique could be due to the access of local anesthetic to the different components of plexus in the sheath.
我们研究了31例接受上肢外科手术的年轻男性患者的臂丛神经阻滞结果。13例患者采用异感技术实施肌间沟阻滞，18例患者采用血管周围技术实施腋路阻滞。两组均注射30毫升含1:200,000肾上腺素的1.5%利多卡因。注射后5分钟和15分钟通过针刺评估感觉阻滞情况。结果显示，肌间沟技术优先阻滞臂丛的头侧神经，而腋路技术对臂丛的头侧和尾侧神经产生相似的阻滞效果。两组间差异具有统计学意义，提示神经阻滞范围取决于穿刺技术本身。两种技术所阻滞神经模式的差异可能是由于局部麻醉药进入鞘内臂丛不同组分的途径不同所致。
