Lenters Tim R, Davies Joanna, Matsen Frederick A
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA 98195, USA.
J Shoulder Elbow Surg. 2007 Jul-Aug;16(4):379-87. doi: 10.1016/j.jse.2006.10.007. Epub 2007 Apr 19.
Interscalene brachial plexus block is a commonly used anesthetic. However, substantial complications can be associated with its use. Our study included 15 years of data from a local medical center and 3 decades of records from the national American Society of Anesthesiology Closed Claims Project. The hospital had 27 peripheral neurologic injuries, 3 central nervous system complications, 6 respiratory complications, and 5 cardiovascular complications. Of these complications, 14 were still present at the most recent follow-up, some causing major compromise of the patient's comfort and function. All central blocks, local toxicities, and respiratory complications resolved. In the hospital series, more experienced anesthesiologists tended to have lower complication rates. The American Society of Anesthesiology Closed Claims database had 20 peripheral neurologic injuries, 10 respiratory complications, 5 central nervous system complications, 4 deaths, 2 emotional disturbances, and 1 other unknown event. Of the complications, 19 were described as permanent. Interscalene brachial plexus block can be accompanied by substantial and disabling complications, especially when administered by less experienced anesthesiologists.
肌间沟臂丛神经阻滞是一种常用的麻醉方法。然而，使用该方法可能会出现严重并发症。我们的研究纳入了当地一家医疗中心15年的数据以及美国麻醉医师协会全国闭合性索赔项目30年的记录。该医院发生了27例周围神经损伤、3例中枢神经系统并发症、6例呼吸系统并发症和5例心血管并发症。在这些并发症中，14例在最近一次随访时仍存在，有些给患者的舒适度和功能造成了严重影响。所有中枢神经阻滞、局部毒性反应和呼吸系统并发症均已缓解。在医院的病例系列中，经验更丰富的麻醉医生并发症发生率往往较低。美国麻醉医师协会闭合性索赔数据库中有20例周围神经损伤、10例呼吸系统并发症、5例中枢神经系统并发症、4例死亡、2例情绪障碍和1例其他不明事件。在这些并发症中，19例被描述为永久性的。肌间沟臂丛神经阻滞可能会伴有严重且致残的并发症，尤其是在经验不足的麻醉医生操作时。
