Comparison of the anesthetic effects between ultrasound-guided brachial plexus block via costoclavicular approach and ultrasound-guided infraclavicular brachial plexus block via coracoid approach in operations of forearm and hand
10.12089/jca.2018.04.006
- VernacularTitle:超声引导下肋锁间隙和喙突入路锁骨下臂丛神经阻滞在前臂或手部术中效果的比较
- Author:
Jing LI
1
;
Ling ZHAO
;
Bin HAN
;
Yan QIAO
;
Lining DONG
Author Information
1. 710077,西安医学院第一附属医院麻醉科
- Keywords:
Costoclavicular;
Coracoid approach;
Infraclavicular brachial plexus block
- From:
The Journal of Clinical Anesthesiology
2018;34(4):341-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effectiveness between ultrasound-guided brachial plexus block via costoclavicular approach and ultrasound-guided infraclavicular brachial plexus block via cora-coid approach.Methods Fifty-eight patients scheduled for forearm or hand surgery,33 males and 25 females,aged 18-70 years,ASA physical status Ⅰ-Ⅲ,were selected in this study.The patients were equally randomized into two groups:the group of brachial plexus block via costoclavicular approach (group A)and group of infraclavicular brachial plexus block via coracoid approach (group B).0.5 % ropivacaine 20 ml was used for local anesthetic.The anatomic depth of brachial plexus nerve,nerve block operation time,sensory and motor blockade situation were recorded.Results Ultrasonic ima-ging showed the brachial plexus was shallower in group A (2.0±1.2)cm than in group B (3.5± 1.8)cm (P<0.05).Nerve block operation time in group A (2.0±1.5)min was less than that in group B (4.0 ± 1.5 )min (P <0.05 ).After 5 minutes and 10 minutes of the local anesthetic inj ection,the sensory blockade rate of the median nerve,the ulnar nerve,the radial nerve and the muscle cutaneous nerve in group A was higher than in group B (P<0.05).After 10 minutes of the inj ection,the motor blockade rate for the ulnar nerve,the radial nerve and the muscle cutaneous nerve was higher in group A than in group B (P<0.05).There were no dyspnea,nausea,vomiting,tinni-tus and other adverse reactions in the two groups.Conclusion The ultrasound-guided costoclaviculari brachial plexus block is more shallower than the subclavicular plexus block in the anatomic depth,and the nerve-blocked-operating time is shorter;at the same time,the former’s sensory and motor block effects is faster than the later.
