摘要
目的 观察末梢灌注指数（tip perfusion index，TPI）的变化能否客观评估臂丛神经阻滞的效果。方法 臂丛神经阻滞下行上肢手术患者70例，ASAl-II级，予以连续监测心电图、无创血压、双上肢脉氧饱和度和TPI，手术室温度控制在24℃-26℃，阻滞前10min静脉注射咪达唑仑0．06mg／kg镇静，记录臂丛神经阻滞阻滞侧上肢神经分布区域的痛觉消失时间，阻滞侧和非阻滞侧手指的TPI。结果 成功的腋路和肌间沟臂丛神经阻滞的非阻滞侧上肢的TPI数值在30min的变化都不明显；与非阻滞侧比较，成功的腋路和肌问沟臂丛阻滞侧的TPI数值分别在8min和6min开始显著增加（P〈0．01）（2．88±0．79vs1．8±0．42，2．70±0．59VS2．02±0．38）；而失败的臂丛阻滞阻滞侧和非阻滞侧的各个时间点的TPI数值变化均不明显。结论 监测TPI的动态变化能客观准确的评价臂丛神经阻滞的效果，与传统的针刺法相比，不仅能更早的监测臂丛神经阻滞的起效，而且简单无创。
Objective To evaluate the availability of tip perfusion index （TPI） changes for objective prediction of successful inbrachial plexus block. Methods seventy ASA I-II patients scheduled for upper extremity operation under brachial plexus block were included. Noninvasive arterial blood pressure, electrocardiogram, bilateral upper extremity oxygen saturation and TPI values were measured. Operating room temperature was controlled at 24℃-26℃. Midazolam 0.06 mg/kg was given intravenously at 10 min before blockade. The onset time of analgesia in blocked upper limb and TPI values of bilateral upper limb were recorded. Results There was no change of TPI values in the unblocked upper limb after axillapy/interscalene approach for brachial plexus block. In axillary approach for brachial plexus block group, TPI values in blocked upper limb started to increase as early as 8 min after the local anesthetic injection. In the interscalene approach for brachial plexus block group, TPI values in blocked upper limb started to increase as early as 6 min. The TPI values during a 30-min period in the failed block patients were not changed. Conclusion TPI provides a simple, early and noninvasive method to evaluate the effect of brachial plexus block
出处
《国际麻醉学与复苏杂志》
CAS
2011年第3期308-310,共3页
International Journal of Anesthesiology and Resuscitation
关键词
末梢灌注指数
臂丛
神经阻滞
Tip perfusion index
Brachial plexus
Nerve block
