何海　黄仕红　黄建华

【摘要】 目的：評价超声引导联合神经刺激仪肌间沟臂丛神经阻滞在老年患者上肢手术中的临床应用效果。方法：选取2017年1月-2018年1月本院拟行上肢手术者120例。按照随机数字表法将其分为超声引导联合神经刺激仪定位组（UN组）、神经刺激仪定位组（N组）、传统方法组（T组），各40例。记录并比较各组麻醉情况、麻醉阻滞效果、麻醉总体效果及并发症。结果：UN组麻醉完成时间、麻醉起效时间均短于N组和T组，麻醉镇痛持续时间长于N组和T组，比较差异均有统计学意义（P<0.05）；

N组麻醉起效时间短于T组，麻醉镇痛持续时间长于T组，比较差异均有统计学意义（P<0.05）；UN组各支配神经分支阻滞完善率均高于N组和T组，麻醉Ⅰ级占比高于N组和T组，比较差异均有统计学意义（P<0.05），且UN组无并发症发生。结论：超声引导联合神经刺激仪应用于老年患者肌间沟臂丛神经阻滞，麻醉操作更快，起效更迅速，镇痛持续时间更长，阻滞更加完善，麻醉相关并发症少，值得在临床上推荐应用。

【关键词】 超声； 神经刺激仪； 臂丛神经阻滞； 老年人

Clinical Application of Ultrasound Combined with Neurostimulator Guided Interscalene Brachial Plexus Block for Elderly Patients Undergoing Upper Limb Surgery/HE Hai，HUANG Shihong，HUANG Jianhua.//Medical Innovation of China，2018，15（14）：107-110

【Abstract】 Objective：To evaluate the effect of ultrasound combined with neurostimulator guided interscalene brachial plexus block for elderly patients undergoing upper limb surgery.Method：A total of 120 patients with upper limb surgery from January 2017 to January 2018 in our hospital were selected.According to the random digital table method，they were divided into ultrasound combined with neurostimulator location group（UN group），the nerve stimulator location group（N group） and traditional method group（T group），40 cases of each group.The anesthetic condition，anesthetic block effect，overall anesthetic effect and complications were recorded and compared.Result：The time of anesthesia completion and the onset time of anesthesia in UN group were shorter than those of N and T group，and the duration of analgesia was longer than that of N and T group，the differences were statistically significant（P<0.05）.The onset time of anesthesia in N group was shorter than that of T group，and the duration of analgesia was longer than that of T group，the differences were statistically significant （P<0.05）.The improvement rate of each innervation branch block in UN group were higher than those of N and T group，and the proportion of Ⅰ grade anesthesia was higher than those of N and T group，the differences were statistically significant（P<0.05），and there was no complication in UN group.Conclusion：Ultrasound combined with neurostimulator is used in the elderly patients with interscalene brachial plexus block，with faster anesthesia，more rapid onset，longer duration of analgesia，more perfect block and less complications related to anesthesia，which is worthy of clinical application.

【Key words】 Ultrasound； Neurostimulator； Brachial plexus block； Elderly people

First-authors address：Huizhou Shuikou Peoples Hospital，Huizhou 516003，China

doi：10.3969/j.issn.1674-4985.2018.14.026

臂丛神经阻滞已广泛应用于上肢的手外科和骨科手术，具有安全可靠、操作方便、效果确切、镇痛时效长、对循环呼吸影响轻微等诸多优点[1-2]。相较于其他麻醉方式，尤其在老年人的应用中，术后可加速老年患者的康复，减少围术期并发症的发生[3]。随着可视化及神经刺激定位技术的逐渐普及，可有效地提高臂丛神经阻滞的完善率和成功率。本文拟对超声引导联合神经刺激仪下行肌间沟臂丛神经阻滞进行研究，探讨其在老年患者上肢手术中临床应用的有效性及安全性。……