超声引导下局麻药物复合辅助药物用于臂丛神经阻滞效果研究

Effect of Ultrasound-Guided Local Anesthesia Combined with Adjuvant Drugs on Brachial Plexus Block

摘要: 臂丛神经阻滞麻醉是局部麻醉中的一种，是将局部麻醉药注入臂丛神经周围使其所支配的区域产生神经传导阻滞的麻醉方法，为临床上常用的局部麻醉方法之一。近年来随着手术部位和方式的精确，臂丛神经阻滞麻醉被广泛应用于各种上肢手术中。在上肢解剖结构中，神经常伴行血管，随着可视化技术的发展，目前临床中的穿刺技术有了巨大的发展，超声引导下的臂丛神经阻滞麻醉较前使用盲法穿刺注射取得了较好的效果，有能够缩短操作时间、减少血管神经的穿刺伤害等优点。目前临床上多采用腋路法及肌间沟入路法，罗哌卡因作为局部麻醉药物被广泛应用于臂丛神经阻滞麻醉，多数国内外研究证明，在臂丛神经阻滞麻醉中单独使用罗哌卡因，存在阻滞不完善、起效慢等缺点，且多数患者认为手术后局麻药神经阻滞时效过后，疼痛出现明显，常影响患者术后正常生活及康复训练。

Abstract: Brachial plexus block anesthesia is a kind of local anesthesia. It is an anesthesia method of injecting local anesthetic around the brachial plexus nerve to produce nerve conduction block. It is one of the commonly used local anesthesia methods in clinical practice. Recently, with the precision of the surgical site and manner, brachial plexus block anesthesia has been widely used in various upper limb surgeries. In the upper limb anatomy, nerves often accompany blood vessels, with the devel-opment of visualization technology, the current clinical puncture technology has the great devel-opment, ultrasound guidance under the brachial plexus nerve block anesthesia than before using blind puncture injection has achieved better results, can shorten the operation time and reduce the vascular nerve puncture injury, etc. Currently, in clinical axillary method and muscle groove meth-od, ropivacaine as a local anesthetic drug is widely used in brachial plexus nerve block anesthesia, Most studies at home and abroad have proved that the use of ropivacaine alone in brachial plexus block has the disadvantages of imperfect block, slow onset, etc. and most patients think that after surgery local anesthetic nerve block time, pain is obvious, which often affects patients with postop-erative normal life and rehabilitation training.