静脉局部麻醉在重度手外伤院前急救中的应用比较  

作　　者：代党会[1] 田现民[1] 李军[1] 

机构地区：[1]河南煤业化工集团鹤煤公司第二职工医院,458010

出　　处：《当代医学》2012年第2期50-51,共2页Contemporary Medicine

摘　　要：目的探讨静脉局部麻醉在院前急救重度手外伤中的镇痛效果和对患者心率(HR)、呼吸频率(RR)及收缩压(SBP)的影响。方法将58例重度手外伤患者随机均分为两组,两组均在止血、包扎等院前急救的基础上治疗组实施利多卡因静脉局部麻醉镇痛,对照组实施静脉注射芬太尼镇痛。两组均在给药后5min观察镇痛效果,15min观察SBP、HR、RR变化。同时进行患肢固定,搬运和护送至医院。结果治疗组镇痛效果显著优于对照组(P<0.05),与镇痛前比较两组在镇痛后15min时HR、SBP均明显下降(P<0.05),且治疗组比对照组下降明显(P<0.05)。结论静脉局部麻醉在重度手外伤患者院前急救中的镇痛效果很明显,并能有效降低血压和心率,减少应激反应。Objective To investigate the analgesic effect on Intravenous regional anesthesia in severe hand injuries ofpre-hospital care, and the influence of heart rate （HR）, respiration rate （RR） and systolic blood pressure （SBP）. Methods Fifty-eight patients with severe hand injury patients were divided randomly into two groups, on the basis of pre-hospital care, which were bleeding,bandaging and so on, the treatment group received the lidocaine of intravenous local analgesia, while intravenous injection of fentanyl in control group analgesia. Both groups were observed the analgesic effect after 5min, and the ch~,nges of SBP, HR, RR after 15min. Meanwhile, limbs were fixed,transported and escorted to the hospital. Results The analgesic effect of the treatment group was significantly better than the control group （P〈0.05）. Compared to the pre-analgesic, HR, SBP decreased significantly （P〈0.05） in the two groups after 15rain, the treatment group decreased more significantly than the control group （P〈0.05） specially. Conclusion Intravenous regional anesthesia in patients with severe hand injury in pre-hospital analgesic effect is obvious,and can lower blood pressure and heart rate, reduce the stress response effectively.

关 键 词：静脉局部麻醉 重度手外伤 院前急救 芬太尼 

分 类 号：R614[医药卫生—麻醉学]