超声引导下地佐辛复合地塞米松对腋路臂丛神经阻滞在儿童急诊手外伤手术中的运用分析  

Application of dezocine combined with dexamethasone Under the guidance of ultrasound on axillary brachial plexus block in the emergency treatment of hand trauma in children

作　　者：张晓侠[1] 王志学[1] 聂明辉[1] 刘新伟[1] 李汝泓[1] 于铁莉[1] 董龙[1] 

机构地区：[1]承德医学院附属医院,河北067000

出　　处：《中国地方病防治》2017年第6期679-679,681,共2页Chinese Journal of Control of Endemic Diseases

基　　金：承德市科学技术研究与发展计划项目(201601A038)

摘　　要：目的目的:探究在超声引导下地佐辛复合地塞米松对腋路臂丛神经阻滞在儿童急诊手外伤手术中运用效果,为临床提供有效依据。方法选择2014年2月至2015年10月在我院门诊急诊就诊的拟行手部外伤手术的儿童112例,按随机数表法将112例患者分为超声引导下地佐辛复合地塞米松经腋路臂丛神经阻滞麻醉组(观察组)和传统的腋路臂丛神经阻滞麻醉组(对照组),每组各56例,对其进行比较分析。结果两组患者在注入麻药后在5min、10min、15min后观察组桡神经的阻滞有效率要明显优于对照组,在注入麻醉药物10min、15min后观察组尺神经和正中神经的阻滞有效率也要明显优于对照组(P<0.05);观察组患者在麻醉起效时间、阻滞完全时间上均要明显短于对照组(P<0.05),在麻醉持续时间上观察组要明显长于对照组(P<0.05)。术后两组患者在6h、12h、18h、24h、48h VAS评分上,观察组要明显低于对照组(P<0.05)。结论在儿童上肢手术中利用超声引导下地佐辛复合地塞米松经腋路臂丛神经阻滞麻醉操作方便,成功率高,能够增强腋路臂丛神经阻滞的效果,且术后并发不良反应少,值得推广应用。Objective To explore the application of dezocine combined with dexamethasone under the guidance of ultrasound on axillary brachial plexus block in the emergency treatment of hand trauma in children, to provide an effective basis for the clinic. Methods 112 cases From February 2014 to October 2015 in the emergency department of our hospital of hand trauma were re- searched. They were randomly divided into observation group （ dezocine combined with dexamethasone under the guidance of ul- trasound} and control group （Traditional axillary brachial plexus block anesthesia}, 56 cases in each group, their effect were compared with acb other. Results After the injection after anesthetic of 5min, 10rain and 15min ,observation group＇s radial nerve block group efficiency was superior to the control group, After 10min, 15min of injection of anesthetic drugs block of ulnar nerve and median nerve of the observation group were significantly better than the control group （ P〈0.05 ） ; patients in the obser- vation group＂ onset time of anesthesia, time of completely block were significantly shorter than the control group （ P〈0.05 ） , the observation group was significantly longer than the control group in the anesthesia duration [ P〈0.05 ）. Tbe VAS scores of 6h, 12h, 18h, 24h and 48h, control group were lower the observation group （ P〈0.05 ）. Conclusion In children with upper extremi- ty surgery using ultrasound-guided dezocine combined with dexamethasone via axillary brachial plexus block anesthesia has the advantages of convenient operation, high success rate, it can enhance the axillary brachial plexus block effect, and with less post- operative adverse reactions, it is worthy of popularization and application.

关 键 词：超声 地佐辛 地塞米松 腋路神经阻滞 儿童手外伤 

分 类 号：R969[医药卫生—药理学]