Department of Anaesthesiology, Intensive Medicine and Pain Therapy, Ulm University and Rehabilitation Hospital (RKU), Oberer Eselsberg 45, 89081, Ulm, Germany.
J Anesth. 2012 Aug;26(4):610-3. doi: 10.1007/s00540-012-1366-x. Epub 2012 Mar 4.
In a prospective controlled trial to compare conventional interscalene brachial plexus block (ISBPB) using anatomic landmarks and electro-stimulation with a combined technique of ultrasound guidance followed by nerve stimulation, 60 patients were randomized into 2 matched equal groups: Group A using nerve stimulation (NS) alone and Group B using the combination of ultrasound and NS. The time to detect the plexus (3.9 ± 4 min in Group A and 3.3 ± 1.4 min in Group B) was not significantly different. We needed to reposition the needle once (n = 13) or twice (n = 4) in Group B. First-shot motor response was achieved in all but one patient in Group A; here we were only able to locate the plexus by use of ultrasound. None of the patients needed general anaesthesia. There were no significant differences between postoperative pain, motor power, or patient's satisfaction. ISBPB seems similarly effective using electro-stimulation and ultrasound if performed by experienced anesthesiologists.
在一项前瞻性对照试验中，我们比较了传统的解剖定位和电刺激肌间沟臂丛阻滞（ISBPB）与超声引导下神经刺激的联合技术，将 60 名患者随机分为 2 组：A 组单独使用神经刺激（NS），B 组使用超声和 NS 的联合技术。检测到丛的时间（A 组 3.9±4 分钟，B 组 3.3±1.4 分钟）无显著差异。B 组中有 13 名患者需要重新定位一次，4 名患者需要重新定位两次。A 组除 1 名患者外，所有患者均获得首次运动反应；在此例中，我们仅通过超声定位到丛。没有患者需要全身麻醉。术后疼痛、运动力量或患者满意度方面无显著差异。如果由经验丰富的麻醉医生进行操作，ISBPB 似乎同样有效，无论使用电刺激还是超声。
