Effect of corner pocket injection technique on supraclavicular brachial plexus obstruction and diaphragmatic paralysis
Objective To analyze the clinical efficacy of corner pocket injection technique and its effect on diaphragmatic paralysis after supraclavicular brachial plexus block.Methods From January 2020 to December 2021,a total of 80 patients performed operation under brachial plexus block anesthesia were enrolled,which included 52 males and 28 females,aged 20-40 years old with mean age of 30.46 years old;body mass index(BMI)was 17.42-28.01 kg/m2 with mean BMI of 22.51 kg/m2.According to American Society of Anesthesiologists(ASA),there were 24 cases of grade Ⅰ,40 of grade Ⅱ,and 16 of gradeⅢ.The operations were performed on elbow in 24 cases,forearm in 21,wrist in 27 and hand in 8.All of them were ran-domly divided into experimental group(n=40)and control group(n=40).The control group was anesthetized by traditional nerve plexus block,while experimental group was anesthetized by ultrasonic-guided corner pocket injection technology.The diaphragmatic mobility and pulmonary function indexes of 2 groups before anesthesia and 30 minute post anesthesia were compared,and the incidence of diaphragmatic paralysis and complications between 2 groups were compared.The diaphrag-matic paralysis at 30-minute after block was set as the terminal;the diaphragmatic mobility and risk of diaphragmatic paral-ysis at 30-minute after block between 2 groups were compared.Results The excellent rate of anesthesia in experimental group was significantly higher than that in control group[92.5％(37/40)vs 70％(28/40).P＜0.05].The onset time of sensory and motor block were significantly shorter than those of control group[(5.41±1.09)minutes vs(6.84±1.65)minutes,(9.06±1.27)minutes vs(11.98± 2.71)minutes],but the durations were significantly longer than those of control group[(404.96±89.73)minutes vs(11.98±2.71)min-utes,(417.93±91.78)minutes vs(300.86±51.92)minutes](P＜0.05).After block,the diaphragm mobility and pulmonary function in-dexes of experimental group were statistically significantly higher than those of control group(P＜0.05).The incidence of diaphrag-matic paralysis and complications in experimental group were significantly lower than those in control group[12.5％(5/40)vs 37.5％(15/40),7.5％(3/40)vs 25％(10/40).P＜0.05].The diaphragmatic paralysis was set as the terminal,the diaphragm activity of experi-mental group was greater than that of control group,and risk of diaphragmatic paralysis was delayed in control group(P＜0.05).Con-clusion It is demonstrated that the anesthesia effect of corner pocket injection technique is better than that of traditional nerve plexus block anesthesia,which has little side effect on diaphragmatic paralysis and less postoperative adverse reaction.
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万方数据
维普
