肌间沟臂丛神经阻滞联合全身麻醉下行锁骨、肱骨手术效果观察  

Observation on the effect of clavicle and humerus surgery under general anesthesia and interscalene brachial plexus block

作　　者：奚胜 XI Sheng(Beijing Water Resource Hospital,Beijing 100036,China)

机构地区：[1]北京水利医院,100036

出　　处：《中国实用医药》2021年第14期69-72,共4页China Practical Medicine

摘　　要：目的探究在锁骨、肱骨手术中应用肌间沟臂丛神经阻滞联合全身麻醉的效果。方法60例行锁骨、肱骨手术的患者,随机分为对照组和观察组,每组30例。对照组采用全身麻醉,观察组在对照组基础上联合肌间沟臂丛神经阻滞麻醉。比较两组患者麻醉效果,血压、心率水平,拔管时间,麻醉用药不良反应发生情况。结果两组麻醉优良率对比差异无统计学意义(χ^(2)=1.964,P=0.161>0.05)。术中,观察组患者收缩压最高值为(93.4±8.5)mm Hg(1 mm Hg=0.133 kPa)、最低值为(90.5±6.2)mm Hg,舒张压最高值为(62.0±7.2)mm Hg、最低值为(59.8±3.3)mm Hg,心率最高值为(77.2±4.4)次/min、最低值为(75.2±4.1)次/min;对照组患者收缩压最高值为(132.5±9.7)mm Hg、最低值为(83.6±9.0)mm Hg,舒张压最高值为(83.8±9.2)mm Hg、最低值为(57.8±2.9)mm Hg,心率最高值为(88.2±3.3)次/min、最低值(58.5±4.2)次/min。术中,观察组患者的收缩压最高值、舒张压最高值、心率最高值均低于对照组,收缩压最低值、舒张压最低值、心率最低值均高于对照组,差异具有统计学意义(P<0.05)。观察组患者拔管时间为(12.5±3.5)min,短于对照组的(16.8±6.5)min,差异具有统计学意义(t=3.190,P=0.002<0.05)。观察组患者的麻醉用药不良反应发生率6.67%低于对照组的26.67%,差异具有统计学意义(χ^(2)=4.320,P=0.038<0.05)。结论在锁骨、肱骨手术中行肌间沟臂丛神经阻滞联合全身麻醉效果显著,可明显抑制患者术中、术后应激反应,减少麻醉不良反应,利于手术的顺利进行和术后康复。Objective To investigate the effect of clavicle and humerus surgery under general anesthesia and interscalene brachial plexus block.Methods A total of 60 patients undergoing clavicle and humerus surgery were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with general anesthesia,and the observation group was treated with interscalene brachial plexus block based on the control group.The anesthesia effect,blood pressure,heart rate,extubation time,and occurrence of adverse reactions to anesthesia drugs were compared between the two groups.Results There was no statistically significant difference in excellent anesthesia rate between the two groups(χ^(2)=1.964,P=0.161>0.05).During operation,the highest systolic blood pressure was(93.4±8.5)mm Hg(1 mm Hg=0.133 kPa)in the observation group,the lowest was(90.5±6.2)mm Hg;the highest diastolic blood pressure was(62.0±7.2)mm Hg,and the lowest was(59.8±3.3)mm Hg;the highest heart rate was(77.2±4.4)beats/min,and the lowest was(75.2±4.1)beats/min.The highest systolic blood pressure was(132.5±9.7)mm Hg in the control group,the lowest was(83.6±9.0)mm Hg;the highest diastolic blood pressure was(83.8±9.2)mm Hg,the lowest was(57.8±2.9)mm Hg;the highest heart rate was(88.2±3.3)beats/min,the lowest was(58.5±4.2)beats/min.During operation,the highest systolic blood pressure,diastolic blood pressure and heart rate of the observation group were lower than those of the control group,and lowest systolic blood pressure,diastolic blood pressure and heart rate were higher than those of the control group.All the difference was statistically significant(P<0.05).The extubation time(12.5±3.5)min of the observation group was shorter than(16.8±6.5)min of the control group,and the difference was statistically significant(t=3.190,P=0.002<0.05).The incidence of adverse reactions to anesthesia drugs 6.67%of the observation group was lower than 26.67%of the control group,and the difference was statistically significant(χ

关 键 词：肌间沟 臂丛神经阻滞 全身麻醉 锁骨手术 肱骨手术 麻醉效果 

分 类 号：R614.2[医药卫生—麻醉学]