Application Of Brachial Plexus Nerve Block Guided By Ultrasound In Patients With Obesity

Objective:Comparative evaluation of ultrasonic positioning and body positioning groove brachial plexus block between muscle of upper of obese patients in difficult operation of clinical effect.Methods:Randomly selected from the second hospital of jilin university in September2012to September2013, proposed by muscle ditch brachial plexus block on upper extremity surgery between62cases of patients with obesity, in patients with American Society of Anesthesiologists(ASA) grade Ⅰ～Ⅱ level, BMI in30kg/m2above. Using single blind method will be randomly divided into two groups: positioning of the brachial plexus nerve block guided by ultrasound group, namely the ultrasound group (group U), and the body susceptible to locate the brachial plexus block set, namely the control group (group C), each group of31people. Group U outside of the planar imaging guided by ultrasound technology is adopted to improve the ditch between the muscle of brachial plexus block anesthesia, group C with traditional susceptibility positioning method for groove between the muscle of the body surface of brachial plexus block anesthesia. Local anesthetics with concentration of0.5%Ropivacaine Hydrochloride. Record the time required to operate a complete, radial nerve, ulnar nerve, median nerve block starting time and Block rate of perfec, the dosage of the drug, anesthesia effects and postoperative complications.Results:1. The main branches of brachial plexus block anesthesia work time is:Group U of ulnar nerve (7.3±2.4) min, group C (19.3±3.2) min; Group U of radial nerve (4.7±3.6) min, group C (14.2±1.9) min; Group U of median nerve (5.6±1.8) min, group C (16.0±2.2) min. Anesthetic effect to time U group were significantly less than that of group C.(P<0.05)2. Group U in three main branch brachial plexus (radial nerve, ulnar nerve and median nerve), the block of success rate are96.8%,93.5%and96.8%respectively, group C were48.4%,61.3%and77.4%, respectively. Power of group U is significantly higher than group C.(P<0.05)3. Group U of local anesthetic drug dosage for ml (16.4±2.1), group C (27.2±2.8) for ml, drug dosage U group was obviously lower than that of group C.(P<0.05)4. U group of excellent and good anesthetic effect is far higher than that of group C, while the anesthetic effect of the poor is far lower than that of group C, the success rate of anesthesia is obviously higher than that of group C.(P<0.05)5. Only1person U group of31patients blood vessel punctured,10cases of pricking blood vessels, local anesthetics poisoning in1case, Horner syndrome occurred in3case. Incidence of postoperative complications and adverse reaction of U group were significantly lower than that of group C.(P<0.05)Conclusion:Ultrasound-guided interscalene brachial plexus block may shorten the execution time and the onset time, and provide excellent block with fewer complications.