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神经刺激器引导下喙突入路臂丛神经阻滞中后束定位的作用：与超声引导相比。

Role of positioning posterior cord on coracoid approach brachial plexus block guided by nerve stimulator: Compared with guided by ultrasound.

作者信息

He Wensheng, Liu Zhuo, Wu Zhenyu, Liu Wenchao, Sun Haijun, Yang Xiaochun

机构信息

Department of Anesthesia, the First Hospital of Qinhuangdao Affiliated to Hebei Medical University, Qinhuangdao, Hebei Province, China.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8428. doi: 10.1097/MD.0000000000008428.

DOI:10.1097/MD.0000000000008428
PMID:29137028
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5690721/
Abstract

BACKGROUND

Coracoid approach is efficient and safe for brachial plexus block, and is guided by nerve stimulator or ultrasound in general. Many trials have proved that ultrasonic guidance was more efficacious than nerve stimulator guidance. We hypothesized that positioning posterior cord could enhance the anesthesia effect of coracoid approach brachial plexus block (CABPB) guided by nerve stimulator.

METHODS

Eighty patients were randomized into 2 groups to receive CABPB with positioning posterior cord guided by nerve stimulator (group A) or CABPB guided by ultrasound (group B). Success rate, procedure time, and onset time of sensory or motor block were recorded.

RESULTS

Success rate was similar in 2 groups (89.7% in group A vs 87.5% in group B, P > .05). Procedure time was longer in group A (8 minutes), as compared with group B (4 minutes; P < .05). The difference of onset time of sensory and motor block was not significant between the 2 groups. The onset time of sensory and motor block for musculocutaneous nerve was significantly shorter in group A, as compared with group B (P < .05).

CONCLUSION

The 2 technologies are equivalent regarding success rate, safety, and onset time of sensory or motor block. Positioning posterior cord in CABPB guided by nerve stimulator is efficacious for upper extremity surgery.(URL: http://www.chictr.org.cn/listbycreater.aspx ID: ChiCTR-INR-16009091 DATE: 25/8/2016).

摘要

背景

喙突入路用于臂丛神经阻滞高效且安全，一般在神经刺激器或超声引导下进行。许多试验已证明超声引导比神经刺激器引导更有效。我们推测在神经刺激器引导下定位后束可增强喙突入路臂丛神经阻滞（CABPB）的麻醉效果。

方法

80例患者随机分为两组，分别接受在神经刺激器引导下定位后束的CABPB（A组）或超声引导下的CABPB（B组）。记录成功率、操作时间以及感觉或运动阻滞的起效时间。

结果

两组成功率相似（A组为89.7%，B组为87.5%，P>0.05）。A组操作时间更长（8分钟），而B组为4分钟（P<0.05）。两组感觉和运动阻滞的起效时间差异不显著。与B组相比，A组肌皮神经感觉和运动阻滞的起效时间显著更短（P<0.05）。

结论

在成功率、安全性以及感觉或运动阻滞的起效时间方面，这两种技术相当。在神经刺激器引导下的CABPB中定位后束对上肢手术有效。（网址：http://www.chictr.org.cn/listbycreater.aspx 编号：ChiCTR-INR-16009091 日期：2016年8月25日）

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd46/5690721/d9d82945ddef/medi-96-e8428-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd46/5690721/abe958f9804d/medi-96-e8428-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd46/5690721/d9d82945ddef/medi-96-e8428-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd46/5690721/abe958f9804d/medi-96-e8428-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd46/5690721/d9d82945ddef/medi-96-e8428-g002.jpg

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2
Comparison of the Supraclavicular, Infraclavicular and Axillary Approaches for Ultrasound-Guided Brachial Plexus Block for Surgical Anesthesia.用于手术麻醉的超声引导下臂丛神经阻滞的锁骨上、锁骨下及腋路入路比较
Rambam Maimonides Med J. 2016 Apr 19;7(2):e0013. doi: 10.5041/RMMJ.10240.
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Ultrasound guidance improves the success rate of axillary plexus block: a meta-analysis.超声引导可提高腋神经丛阻滞的成功率：一项荟萃分析。
Braz J Anesthesiol. 2016 Mar-Apr;66(2):115-9. doi: 10.1016/j.bjane.2015.01.002. Epub 2015 Oct 1.
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Infraclavicular brachial plexus block: Comparison of posterior cord stimulation with lateral or medial cord stimulation, a prospective double blinded study.锁骨下臂丛神经阻滞：后束刺激与外侧或内侧束刺激的比较，一项前瞻性双盲研究。
Saudi J Anaesth. 2013 Apr;7(2):134-7. doi: 10.4103/1658-354X.114054.
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Korean J Anesthesiol. 2013 Apr;64(4):327-33. doi: 10.4097/kjae.2013.64.4.327. Epub 2013 Apr 22.
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Can J Anaesth. 2009 Nov;56(11):812-8. doi: 10.1007/s12630-009-9170-2.
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Is ultrasound guidance superior to conventional nerve stimulation for coracoid infraclavicular brachial plexus block?超声引导在喙突下锁骨上臂丛神经阻滞中是否优于传统神经刺激法？
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