超声引导下臂丛神经阻滞在儿童上肢手术中的应用

发布时间：2018-04-16 04:27

本文选题：超声 + 臂丛神经阻滞　；参考：《山东医药》2015年02期

【摘要】：目的观察超声引导下臂丛神经阻滞在儿童上肢手术中的应用效果。方法择期行上肢手术的患儿80例,其中肱骨骨折35例,尺桡骨骨折30例,前臂血管瘤11例,多指畸形4例。采用随机数字表法将80例患儿分为两组,对照组采用神经刺激器定位下行臂丛神经阻滞,观察组采用超声引导下行臂丛神经阻滞。比较两组麻醉操作时间、起效时间、镇痛维持时间、恢复室停留时间、术中辅助麻醉使用氯胺酮量、麻醉总有效率及麻醉过程中并发症及不良反应发生率。结果观察组麻醉起效时间、恢复室停留时间及术中氯胺酮用量均少于对照组,麻醉镇痛作用维持时间长于对照组(P均0.05)。观察组患儿神经阻滞30 min后尺动脉舒张末期血流速度、平均速度及血流量均高于对照组,阻力指数及搏动指数低于对照组(P均0.05)。观察组麻醉总有效率高于对照组,不良反应发生率低于对照组(P均0.05)。结论超声引导下臂丛神经阻滞用于儿童上肢手术麻醉起效快,效果好,安全性较高。
[Abstract]:Objective to observe the effect of ultrasound-guided brachial plexus block in children with upper limb operation.Methods A total of 80 children with upper limb operation were selected, including 35 humeral fractures, 30 ulnar and radial fractures, 11 forearm hemangiomas and 4 polydigital deformities.80 children were randomly divided into two groups: the control group was treated with nerve stimulator for brachial plexus block, and the observation group was guided by ultrasound to block the brachial plexus nerve.The operation time, the onset time, the analgesic maintenance time, the recovery chamber stay time, the amount of ketamine, the total effective rate of anesthesia and the incidence of complications and adverse reactions during anesthesia were compared between the two groups.Results the onset time of anesthesia, the residence time of recovery chamber and the dosage of ketamine during operation in the observation group were less than those in the control group, and the maintenance time of the analgesic effect was longer than that of the control group (P < 0.05).After 30 min of nerve block, the blood flow velocity, mean velocity and blood flow of ulnar artery in the observation group were higher than those in the control group, and the resistance index and pulsatility index were lower than those in the control group (P < 0.05).The total effective rate of anesthesia in the observation group was higher than that in the control group, and the incidence of adverse reactions was lower than that in the control group (P < 0.05).Conclusion Ultrasound-guided brachial plexus block is effective, effective and safe in children with upper limb operation.
【作者单位】：武汉市第五医院;
【分类号】：R726.1

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