双上肢手术经喉罩吸入七氟醚复合臂丛阻滞麻醉的疗效观察  

Effect of Double Upper Limb Surgery on Laryngeal Mask Inhalation of Sevoflurane Combined with Brachial Plexus Block Anesthesia

作　　者：陈文雄[1] 黄力超 欧阳文博[1] 梁健群[1] 潘燕桃 苏慧 CHEN Wen - xiong , HUANG Li - chao , OUANG Wen - bo(Zhaoqing first People ＇s hospital, Guangdong 52604)

机构地区：[1]肇庆市第一人民医院,广东肇庆526040

出　　处：《中国伤残医学》2018年第11期18-19,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨双上肢手术经喉罩吸入七氟醚复合臂丛阻滞麻醉的疗效.方法：选取60例于2015年1月～2017年1月期间在我院行双上肢手术的患者,随机分为对照组（采用气管内插管全身麻醉,n=30）与观察组（采用经喉罩吸入七氟醚复合臂丛阻滞麻醉,n=30）.观察和记录麻醉前（T1）、插入喉罩或气管导管时（T2）、喉罩或气管导管拔除时（T3）时的HR、MAP、SpO2等血流动力学指标,观察2组麻醉效果,术后不良反应.结果：T2、T3时,2组患者的HR均明显高于T1时,且对照组较观察组显著要高,对照组患者T2、T3时的MAP显著高于同期观察组及T1时（P〈0.05）,2组各时间点的SpO2比较无明显差异（P〉0.05）;观察组患者术后VAS评分、苏醒时间均显著低于对照组（P〈0.05）;观察组术中芬太尼、顺阿曲库铵用量显著低于对照组（P〈0.05）;苏醒期,观察组躁动、恶心呕吐发生率显著低于对照组（P〈0.05）.结论：在双上肢手术中采用经喉罩吸入七氟醚复合臂丛阻滞麻醉,可使麻醉和手术过程更平稳,患者术后苏醒快,疼痛反应小,安全性较高,效果优于单纯气管插管全麻,具有推广价值.Objective： ： To investigate the effect of double upper limb surgery inhalation of sevoflurane combined with brachial plexus block anesthesia. Methods： Sixty patients who underwent double upper limb surgery in our hospital from January 2015 to January 2017 were randomly divided into control group （n = 30 with tracheal intubation, n = 30） and observation group （using larynx Inhalation of sevoflurane compound brachial plexus block anesthesia, n = 30）. （T2）, laryngeal mask or tracheal tube （rib）, and observe the hemo- dynamic parameters such as HR, MAP and SpO2 betore anesthesia （ T1 ）, insertion of laryngeal mask or tracheal tube （T2） Postoperative adverse reactions. Results： T2 and T3 were significantly higher in both groups than in T1, and the control group was significantly higher than that in the observation group. MAP in the control group was significantly higher than that in the control group （P 〈 0.05 （ P 〈 0. 05）. The VAS score and awakening time in the observation group were significantly lower than those in the control group （ P 〈 0.05）. In the observation group, the fentanyl and cis The dosage of atracurium was significantly lower than that of the control group （ P 〈 0.05 ）. The incidence of restlessness and nausea and vomiting in the observation group was significantly lower than that in the control group （P 〈 0.05 ）. Conclusion ： In the double upper limb operation, the laryngeal mask inhalation sevoflurane combined with brachial plexus block anesthesia can make the anesthesia and surgical procedure more stable, the patient is quicker after the recovery, the pain is small, the safety is higher, the effect is better than the simple trachea Intubation of general anesthesia, with the promotion of value.

关 键 词：臂丛阻滞麻醉 七氟醚 喉罩 双上肢手术 

分 类 号：R614[医药卫生—麻醉学]