四种肌间沟臂丛神经阻滞方法在肥胖患者上肢手术中的应用效果比较

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Abstract Objective To compare the application effect of blind probe method，nerve stimulator guidance method，ultrasonic guidance method and ultrasound combined with nerve stimulator guidance method for the intermuscular sulcus brachial plexus block in the upper limb surgery for obese patients.Methods A total of 120 obese patients who underwent elective upper extremity surgery in Foshan Sanshui District People′s Hospital of Guangdong Province from January to December 2017 were selected as sudy subjects.They were divided into A，B，C and D groups according to the random number table method，30 cases in each group.Traditional anatomical localization to find the heterosexual method （blind probe method）was used in group A，nerve stimulator guidance method was used in group B，ultrasonic guidance method was used in group C，and ultrasound combined with nerve stimulator guidance method was used in group D.The operation completed time for nerve block，the onset time of sensory nerve block，the block improvement effect，and total incidence rate of complications were compared among the four groups.Results The operation completed time for nerve block in group B，C，and D was significantly shorter than that in group A，and the differences were statistically significant（P＜0.05）.The operation completed time for nerve block in group C and D was significantly shorter than that in group B，and the differences were statistically significant（P＜0.05）.The operation completed time for nerve block in group D was significantly shorter than that in group C，and the difference was statistically significant（P＜0.05）.The onset time of sensory nerve block in group B，C，and D was significantly shorter than that in group A，and the differences were statistically significant（P＜0.05）.There was no significant difference in the onset time of sensory nerve block among the B，C，and D groups（P＞0.05）.The block improvement effect in group B，C and D was better than that that in group A，and the differences were statistically significant（P＜0.05）.The block improvement effect in group C and D was significantly better than that that in group B，and the differences were statistically significant（P＜0.05）.The block improvement effect in group D was better than that that in group C，and the difference was statistically significant（P＜0.05）.The total incidence rate of complications in group B，C and D was significantly lower than that that in group A，and the differences were statistically significant（P＜0.05）.There was no significant difference in the total incidence rate of complications between the group B and group C（P＞0.05）.The total incidence rate of complications in group D was significantly lower than that in group B and C，and the differences were statistically significant（P＜0.05）.Conclusion Compared with the blind probe method，the ultrasonic guidance method has the advantages of short operation time，short block effect time，high blockade improvement rate and low complication rate in the intermuscular sulcus brachial plexus block of the upper limb surgery for obese patients.The ultrasound combined with nerve stimulator guidance method can further expand the advantages.

Key words： Intermuscular sulcus brachial plexus block Obese patients Ultrasonic guidance method Blind probe method Nerve stimulator guidance method

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	Articles by authors
	TANG Qun-jie
	YE Wei-biao
	FANG Jian-qin
	HUANG Guang-yong
	ZHENG Jian-yu

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TANG Qun-jie,YE Wei-biao,FANG Jian-qin, et al. Application effect comparison of four intermuscular sulcus brachial plexus block methods in the upper limb surgery for obese patients[J]. 中国当代医药, 2019, 26(6): 81-84转88.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2019/V26/I6/81

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