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目的：比较超声定位和体表异感定位肌间沟臂丛神经阻滞在肥胖患者上肢手术中的疗效。方法选择2013年1月至2014年10月第二军医大学附属长海医院择期行上肢手术的68例肥胖患者为研究对象，依据随机数字表法分为两组，各34例。对照组患者采取体表异感定位肌间沟臂丛神经阻滞，观察组患者则行超声定位。比较两组患者神经阻滞起效时间、神经阻滞效果、麻醉效果及并发症情况。结果观察组和对照组肌皮神经[（4.4±2.1） min 比（9.8±3.6） min]、桡神经[（4.2±1.3） min比（10.6±4.5） min]、正中神经[（6.4±2.5） min 比（15.1±6.6） min]、尺神经[（7.3±3.0） min比（18.0±7.4） min]阻滞起效时间比较差异有统计学意义（P＜0.01）。观察组正中神经、尺神经完全阻滞率、麻醉优良率分别为91.2％（31／34）、82.4％（28／34）、94.1％（32／34），与对照组的58.8％（20／34）、38.2％（13／34）、70.6％（24／34）比较差异有统计学意义（P ＜0.05）。两组并发症发生率比较差异无统计学意义（ P＞0.05）。结论与体表异感定位相比，超声定位肌间沟臂丛神经阻滞起效快、成功率高、麻醉效果良好且并发症相对少，值得临床推广。“,”Objective To compare the clinical effect of body surface ultrasound localization and abnor-mal sensation of interscalene brachial plexus block on the operation of upper limb in obese patients .Methods A total of 68 obese patients who underwent upper limb operation in Changhai Hospital of the Second Mili-tary Medical University from Jan.2013 to Oct.2014 were inlcuded as the research objects,and were divided into two groups according to random number table method,each group of 34 cases.Patients in the control group were given surface paresthesia interscalene brachial plexus block,while patients in observation group underwent ultrasound localization.The nerve block onset time,blocking effect,anesthesia effect and complications of the two groups were compared.Results Block onset time of musculocutaneous nerve[(4.4 ±2.1) min vs (9.8 ± 3.6) min],radial nerve[(4.2 ±1.3) min vs (10.6 ±4.5) min],the median nerve[(6.4 ±2.5) min vs (15.1 ±6.6) min],ulnar nerve[(7.3 ±3.0) min vs (18.0 ±7.4) min] of observation group and control group had statistically significant difference(P<0.01).The median nerve,ulnar nerve anesthesia complete block rate,excellent and good anesthesia rate of the observation group were 91.2%(31/34),82.4%(28/34 ) ,94.1%( 32/34 ) , there were statistically significant difference compared with control group [ 58.8%(20/34),38.2%(13/34),70.6%(24/34),P0.05).Conclusion Compared to surface paresthesia positio-ning,ultrasonic interscalene brachial plexus block has a rapid onset,high success rate,good anesthesia effect and less complications,thus is worthy of clinical promotion.