摘要
目的探讨超声引导下臂丛神经阻滞用于小儿上肢手术的麻醉效果及安全性。方法方便选取该院于2015年2月—2017年10月收治的64例行小儿上肢手术的患儿,随机分为超声引导下臂丛神经阻滞组(A组,n=32)和喉罩全麻组(B组,n=32)。于麻醉前、切皮、术中、术毕记录其血压(BP)、心率(HR)、血氧饱和度(SpO_2),并比较两组麻醉起效时间、苏醒时间、不良反应发生率及术后镇痛效果。结果两组在手术中各观察时间点的BP、HR、SpO_2差异有统计学意义,A组明显低于B组(P<0.01)。两组的苏醒时间[(6.3±4.8)min vs(35.23±4.1)min]比较差异有统计学意义(t=4.76,P<0.01),两组不良反应发生率(6.25%vs 37.5%)和追加镇痛药次数(3.12%vs 25.0%)比较也差异有统计学意义(χ~2=4.293、5.395,P<0.05)。结论超声引导下臂丛神经阻滞简单实用、麻醉起效快、用药少、苏醒时间短,疗效确切、安全可靠,是小儿上肢手术较理想的麻醉方法。
Objective To study the anesthesia effect and safety of ultrasound-guided brachial plexus block in upper limb surgery in children. Methods 64 cases of children with upper limb surgery in our hospital from February 2015 to October2017 were convenient selected and randomly divided into two groups with 32 cases in each, the group A were the ultrasound-guided brachial plexus block patients, the group B were the general anesthesia of laryngeal mask patients, and the BP, HR and SpO_2 before anesthesia, at skin incision, in operation and after surgery, and the anesthesia onset time, awakening time, incidence rate of adverse reactions and postoperative analgesic effect were compared between the two groups. Results The differences in the BP, HR, SpO_2 at various time points between the two groups were statistically significant, and the indicators in the group A were obviously lower than those in the group B（P〈0.01）, and the difference in the awakening time between the two groups was obvious, with statistical significance [（6.3± 4.8）min vs（35.23±4.1）min],（t=4.76,P〈0.01）,and the differences in the incidence rate of adverse reactions and number of additional analgesics between the two groups were statistically significant[（6.25% vs 37.5%）,（3.12% vs 25.0%）], and the differences were statistically obvious（χ~2=4.293、5.395, P〈0.05）. Conclusion The ultrasound-guided brachial plexus block is simple and practical with rapid anesthesia and onset, few medications, short awakening time and the curative effect is definite, and it is safe and reliable, and it is an ideal anesthesia method of upper limb surgery in children.
作者
黄硕
饶荣
王翠宝
许淑珍
卢华辉
HUANG Shuo;RAO Rong;WANG Cui-bao;XU Shu-zeh;LU Hua-hui(Department of Anesthesia, Xiamen Fifth Hospital,Xiamen,Fujian Province,361101 China)
出处
《中外医疗》
2018年第13期187-190,共4页
China & Foreign Medical Treatment
关键词
臂丛神经阻滞
超声
麻醉
小儿
Brachial plexus block
Ultrasound
Anesthesia
Children
作者简介
[通讯作者]黄硕（1979-）,女,福建南平人,在读硕士,副主任医师,研究方向：小儿麻醉,E-mail：huangshuoxm@163.com。
