Abstract：Objective To compare the analgesic efficacy of different continuous auxillary brachial plexus block after elbow stiffness.Methods Ninety patients were randomly and equally allocated into three groups: U group(ultrasound-guided alone), N group( nerve stimulator-guided) and NU group(nerve stimulator-guided and ultrasound-guided). The catheter was placed around radial nerves, respectively. The time taken to place the catheter and injury to blood vessels were recorded, respectively. The numerical rating scale scores(NRS) were assessed at rest and during passive mobilization at 24 h , 48 h and 72 h, postoperatively. The number of times the sufentanil PCA button was pressed was recorded at 72 h,postoperatively and the occurrence of such adverse reactions as nausea, vomiting, itching and respiratory depression was observed.Results The time it took to place the catheter in the N group(5.2±1.6)min was significantly longer than that of U group(3.2±0.5)min and NU group(3.6±1.2)min (P<0.05). The difference of NRS scores was not significant between the three groups at rest or during passive mobilization at 24 h, 48 h and 72 h after operation. There were seven cases of injury to blood vessels in the N group, but there was none in the U group or NU group (P<0.05). The sufentanil PCA button was pressed more often in the N group than in the other two groups(P<0.05).Conclusions The postoperative analgesia effect of the ultrasound guided approach is better than that of the nerve stimulator. Placing the catheter around radial nerves guided by ultrasound can prevent injury to blood vessels.
李玉锦,张大志,王怀江. 不同方式引导腋路置管对肘关节松解术后镇痛的影响[J]. 武警医学, 2017, 28(5): 458-461.
LI Yujin, ZHANG Dazhi, and WANG Huaijiang. Analgesic efficacy of different continuous axillary brachial plexus block after elbow stiffness. Med. J. Chin. Peop. Armed Poli. Forc., 2017, 28(5): 458-461.
Mcgrath B, Elgendy H, Chung F, et al. Thiety percent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5703 patients[J]. Can J Anaesth,2004,51(9):886-891.
[4]
Abrahams M S, Aziz M F, Fu R F et al. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials[J]. Br J Anaesth ,2009, 102(3): 408-417.
[5]
Casati A, Danelli G, Baciarello M, et al. A prospective, randomized comparison between ultrasound and nerve stimulation guidance for multiple injection axillary brachial plexus block[J]. Casati ,2007,106(5):992-996.
[6]
Liu F C, Liou J T, Tsai Y F, et al. Efficacy of ultrasound-guided axillary brachial plexus block: a comparative study with nerve stimulator-guided method[J]. Chang Gung Med J ,2005,28(6): 396-402.
Abrahams M S, Aziz M F, Fu R F, et al. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials[J]. Br J Anaesth,2009,102(3):408-417.
[13]
Ang T L, Kwek A B, Seo D W, et al. A prospective randomized study of the difference in diagnostic yield between endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) needles with and without a side port in pancreatic masses[J]. Endosc Int Open,2015,3(4):E329-333.
2017, Vol. 28 
