超声和神经刺激仪在小儿臂丛神经阻滞中的应用效果比较  

Comparison on the effects of ultrasound-guided and stimulator guided on pediatric brachial plexus block

作　　者：王超平[1] 周旭[1] 张继洛[1] 

机构地区：[1]河南省洛阳正骨医院,河南洛阳471002

出　　处：《中医临床研究》2014年第33期141-142,共2页Clinical Journal Of Chinese Medicine

摘　　要：目的：探索小儿臂丛神经阻滞临床上更安全快捷的方法。方法：30例择期行上肢的儿童（2～12岁），ASA分级1～2级，随机分为超声引导组US和神经刺激仪引导组NS，两组均结合传统的解剖定位。局麻药均为0．25％罗哌卡因和1％利多卡因1：1混合液，药量为0．5mL／kg，观察两组麻醉操作完成时间、阻滞效果、术中静脉药丙泊酚的用量及并发症的发生率。结果：两组患儿手术时间无差异，神经阻滞效果均完善，术中丙泊酚用量少，术后清醒早，US组麻醉操作完成时间明显短于NS组（P〈O．05），且US组并发症发生率明显小于NS组（P〈0．05）。结论：超声在小儿臂从神经阻滞中有明显的优越性，明显缩短麻醉完成时间，减少损伤，降低并发症发生率。Objective： To explore a better clinical method in the treatment of pediatric brachial plexus block. Methods： Thirty patients （ASA Ⅰ or Ⅱ）in the stage of 2-12 years old undergoing upper limb operation were randomized into the ultrasound guided group and the stimulator guided group .They combine anatomical landmark. Local anesthetics was mixture of 1% lidocine and 0.25% ropivacaine, and the dose was 0.5ml/kg.The time of anesthesia,the effect of block ,the dose ofpropofol and the rate of complication were observed. Results： There was no significant difference in the operation time between the two groups. The effects of both groups were good and the total doses ofpropofol were less. The anesthesia time was shorter in the ultrasomld guided group than never stimulator guided group and the rate of complication was lower in US than that in NS （P〈0.05）. Conclusion： Ultrasound guided brachial plexus block with ketamine anesthesia can provide satisfactory anesthesia for children with a quick postoperative recovery and the lower rate of anesthesia complications.

关 键 词：超声引导 神经刺激仪 臂从神经阻滞 

分 类 号：R614.4[医药卫生—麻醉学]