摘要：目的：探讨一种新的并发症少、操作简单、效果佳的锁骨上路臂丛神经阻滞方法。方法：随机选择上肢手术患者50例，随机分为两组：实验组采用改良法锁骨上路臂丛神经阻滞，对照组采用传统法。注入0.33%罗哌卡因+0.66%利多卡因20ml，实验组采用20#动静脉留置针穿刺给药。成功标志：神经异感或触及第一肋或套针置入顺利，采用视觉模拟量表(VAS)和语言模拟量表(VRS)进行疼痛评估。结果：实验组首次成功率100%，而对照组仅为80.2%。两组患者镇痛方面没有明显差异。不良反应方面：对照组误穿血管3例，实验组0例；对照组气胸1例，实验组0例。结论：改良法锁骨上路臂丛神经阻滞技术同传统法相比，操作简便易行、作用确切、并发症少，临床可安全使用。

    关键词：锁骨上路；臂丛神经阻滞；改良；罗哌卡因

    Clinical use of Modified Supra Clavicular Branchial Nerve Block

    CAO Dian-qing,YAO Ye-xing,YANG Guang-ping

    (The Affiliated Hospital of Guangdong Medical College, Guangdong Zhanjiang 524001, China)

    Abstract： Objective： To observe the clinical effect of modified supra-clavicular branchial nerve block. Method： Fifty ASA Ⅰ～Ⅱpatients undergoing elective supra limb surgery were randomly divided into two groups: Patients were anesthetized with modified supra-clavicular branchial nerve block in catheter 20# in experimental group and traditional supra-clavicular branchial nerve block in control group with compounds of ropi- vacaine and lidocaine. Analgesia degree was evaluated by VAS and VRS. Result： Achievement rate of first manipulation in experiment group (100%) was higher than that in control group (80.2%) significantly (P<0.05).There was no significant difference between two groups in analgesia. There was 3 cases with complication of misinjection into vascular and 1 case with complication of pneumothorax in control group, there was no such complication in experiment group. Conclusion： Compared with traditional method, modified supra-clavicular branchial nerve block has such advantages as easy and feasible manipulation, exact action and fewer complication, it deserves to be used widely. ......