双腔喉罩复合臂丛麻醉在老年肱骨外髁颈骨折手术中的应用  

The application double cavity laryngeal mask combined with brachial plexus nerve block in the operation of humerus surgical neck fracture

作　　者：闵金义 

机构地区：[1]当阳市长坂坡医院,湖北当阳444100

出　　处：《基层医学论坛》2016年第12期1597-1599,共3页The Medical Forum

摘　　要：目的观察双腔喉罩+臂丛神经阻滞(肌间沟)麻醉应用于老年肱骨外髁颈骨折手术的麻醉效果和安全性,为临床提供指导。方法选取2014年1月—2015年6月在我院手术的60例老年肱骨外髁颈骨折患者,随机分为对照组和观察组,每组30例,分别采用臂丛神经阻滞+同侧颈浅阻滞(对照组)和双腔喉罩+臂丛神经阻滞(观察组)麻醉。观察2组患者麻醉期间心率(HR)、血压(BP)、血氧饱和度(Sp O2)、呼气末二氧化碳分压(PETCO2)和气道峰压(Ppeak),比较术中镇痛效果及术后并发症的发生情况。结果 2组间每个时间点HR和BP水平差异均有统计学意义(P<0.01),Sp O2、PETCO2、Ppeck差异无统计学意义(P>0.05)。观察组术后并发症发生率低于对照组(P<0.05)。结论双腔喉罩+臂丛神经阻滞用于老年肱骨外髁颈骨折手术,麻醉效果确切,方便可行,安全可靠。Objective To compare the effect of double lumen laryngeal mask ＋ brachial plexus block（interscalene）anesthesia analgesic in senile fracture of the humerus surgical neck,and provide guidance for clinical treatment. Methods 60 patients with proximal humerus surgical neck fractures from January 2014 to June 2015 in our hospital were retrospectively analyzed,which were divided into observation group and control group,30 cases in each group,respectively,using brachial plexus block（intermuscular groove）＋ ipsilateral neck shallow block（control group）and double lumen laryngeal mask ＋ brachial plexus block anesthesia（observation group）. Observe two groups anesthesia during the heart rate（HR）and blood pressure（BP）,blood oxygen saturation（SpO2）,end tidal CO2（PETCO2）and peak airway pressure（Ppeak）,intraoperative analgesia and postoperative complications. Results There were significant differences in the levels of BP and HR in the two groups at each time point（P〈0.01）,SpO2,PETCO2,and Ppeck（P〈0.05）.The postoperative complication rate of the observation group was lower than that of the control group（P〈0.05）.Conclusions The double chamber laryngeal mask and brachial plexus block for surgical neck fracture of humerus in aged patients,anesthesia effect is accurate,convenient and feasible,safe and reliable.

关 键 词：肱骨外髁颈骨折 老年患者 麻醉 双腔喉罩 臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]