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目的研究超声引导下相同剂量肌间沟及锁骨上臂丛阻滞和不同剂量肌间沟臂丛阻滞的麻醉效果，对右侧膈肌运动的影响，对减少膈肌阻滞发生率进行摸索。方法60例右上肢手术的患者，1%利多卡因+0.4%罗哌卡因20ml，随机分为三组，分别为：20ml肌间沟组(IA组)，16ml肌间沟组(IB组)，20ml锁骨上组(S组)。超声引导下行臂丛阻滞，记录各组感觉阻滞效果，运动阻滞效果，并发症及阻滞后5min，30min膈肌移动幅度。结果三组间感觉、运动阻滞效果无显著差异。三组施行臂丛阻滞后5min、30min平静呼吸膈肌阻滞程度，组间比较：S组低于IA组，IA和IB组间无统计学差异；组内比较S组前后差异无统计学意义，IA组和IB组与阻滞前比较，阻滞后均见加重。深呼吸时三组的膈肌阻滞程度比较与平静呼吸时相似。三组仅肌间沟入路20ml组出现一例胸闷，无其他并发症发生。结论相同剂量局麻药臂丛阻滞肌间沟入路比锁骨上入路对膈肌运动影响更大，相同部位肌间沟入路臂丛阻滞20ml和16ml相比膈肌阻滞发生率相差不大。“,”Objective The purpose of this study was to compare the anesthetic ef ect and right hemidiaphragm motion between interscalene and supraclavicular brachial plexus block had the same dose and interscalene brachial plexus block had dif erent dose by Ultrasound guidance ,to study how to reduce the incidence of diaphragmatic paralysis. Methods 60 Patients need Surgery on right Upper limb, 1%Lidocaine+0.4%Ropivacaine 20ml, randomly divided into three groups:20ml supraclavicular group (group S), 20ml interscalene group (group IA),16ml interscalene group (group IB). After ultrasound-guided brachial plexus block, we measured the ef ects of sensory block and motor block, complication and measure the right diaphragmatic paralysis before brachial plexus block, 5min, 30min after brachial plexus block. Results There was no statistics dif erence in the ef ect of sensory block or motor block among the three groups. The quiet breathing of 5 min and 30 min after brachial plexus block, between groups, group S had lower diaphragmatic paralysis than group IA , between group IA and group IB there was no statistics dif erence on diaphragmatic paralysis . Internal group, there was no statistics dif erence in group S, group IA and group IB were deeper than before . When deep breath the degree of diaphragmatic paralysis similar to quiet breathing. There was no complication occur except one patient felt chest tightness .Conclution Between the same dose of interscalene and supraclavicular brachial plexus block, the former had a greater impact on the diaphragm movement. In the interscalene brachial plexus block, 16ml local anesthetic was not reduce the incidence of diaphragmatic paralysis compare to 20ml.