Abstract：Objective To evaluate the effect of axillary brachial plexus block injected beside the artery guided by out-plane technology guided of ultrasound and nerve stimulator.Methods Sixty patients of scheduled for selected bone fracture surgery below elbow in the Third Hospital of Hebei Medical University from September 2015 to September 2016 were prospectively randomized to observation group and control group, 30 patients in each group. Patients in observation group underwent axillary brachial plexus block by out-plane technology guided of ultrasound and nerve stimulator beside axillary artery. Patients in control group performed axillary brachial plexus block by in-plane technology guided by ultrasound and nerve stimulator perineurally. The operation time, the onset time of anesthesia, sensory and motor block effect, the tourniquet tolerance, adverse events, the time of operation of two groups were recorded.Results Sixty patients were successfully completed operation, without complications such as pricking blood vessels and toxicity of local anesthetic comparition of two groups. The operation time of observation group(6.0±1.2)min was shorter than control group (11.5±2.1)min, the anesthesia onset time of observation group (13.0±1.7)min was longer than control group(7.8±1.5) min. The effect of complete motor block rate of observation group 53.3% (16/30) was lower than control group 90.0%(27/30), difference was statistically significant(t=12.464, -12.781, χ2=9.932, all P values﹤0.01). The effect of sensory block, tourniquet toleration and the operation time was similar in two group(all P values＞0.05).Conclusions The operation of axillary brachial plexus block injected beside artery guided by out-plane technology guided of ultrasound and nerve stimulator is simple, safe and effective. It has good clinical application value.
李惠洲, 仝烨峰, 石娜, 吴川, 王秀丽. 超声平面外技术联合神经刺激器腋路动脉旁注药臂丛神经阻滞效果研究[J]. 中华解剖与临床杂志, 2017, 22(6): 495-498.
Li Huizhou,Tong Yefeng,Shi Na,Wu Chuan,Wang Xiuli. The effect observation of axillary brachial plexus block injected beside the artery by ultrasound-guided out-plane and nerve stimulator. Chinese Journal of Anatomy and Clinics, 2017, 22(6): 495-498.
Fenten MG, Schoenmakers KP, Heesterbeek PJ, et al. Effect of local anesthetic concentration, dose and volume on the duration of single-injection ultrasound-guided axillary brachial plexus block with mepivacaine: a randomized controlled trial[J]. BMC Anesthesiol, 2015,15:130. DOI:10.1186/s12871-015-0110-0
[8]
Schwenk ES, Gandhi K, Baratta JL, et al. Ultrasound-guided out-of-plane vs. in-plane interscalene catheters: a randomized, prospective study[J]. Anesth Pain Med, 2015, 5(6):e31111. DOI:10.5812/aapm.31111
[9]
Li X, Fang G, Yang D, et al. Ultrasonic technology improves radial artery puncture and cannulation in intensive care unit (ICU) shock patients[J]. Med Sci Monit, 2016, 22: 2409-2416. DOI:10.12659/msm.896805
[10]
Chin KJ, Alakkad H, Cubillos JE. Single, double or multiple-injection techniques for non-ultrasound guided axillary brachial plexus block in adults undergoing surgery of the lower arm[J]. Cochrane Database Syst Rev, 2013,(8): CD003842. DOI:10.1002/14651858.CD003842.pub4
[11]
Bernucci F, Gonzalez AP, Finlayson RJ, et al. A prospective, randomized comparison between perivascular and perineural ultrasound-guided axillary brachial plexus block[J]. Reg Anesth Pain Med, 2012, 37(5): 473-477. DOI:10.1097/AAP.0b013e3182576b6f
[12]
Cho S, Kim YJ, Baik HJ, et al. Comparison of ultrasound-guided axillary brachial plexus block techniques: perineural injection versus single or double perivascular infiltration[J]. Yonsei Med J, 2015, 56(3): 838-844. DOI:10.3349/ymj.2015.56.3.838
Ambi U, Bhanupriya P, Hulkund SY, et al. Comparison between perivascular and perineural ultrasound-guided axillary brachial plexus block using levobupivacaine: A prospective, randomised clinical study[J]. Indian J Anaesth, 2015, 59(10): 658-663. DOI:10.4103/0019-5049.167476
2017, Vol. 22 
