电针复合臂丛神经阻滞在上肢骨折手术麻醉中的应用观察  

作　　者：叶园园 张一帆 

机构地区：[1]南阳市中心医院麻醉科,473000

出　　处：《中国疗养医学》2021年第12期1301-1303,共3页Chinese Journal of Convalescent Medicine

摘　　要：目的探究电针复合臂丛神经阻滞在上肢骨折手术麻醉中的应用价值。方法选取2018年4月至2021年4月在南阳市中心医院行上肢骨折手术麻醉的患者共136例,采用随机数字表分为观察组和对照组,各68例。对照组予以臂丛神经阻滞麻醉,观察组予以电针复合臂丛神经阻滞麻醉。比较两组患者手术时麻醉状况(麻醉阻滞起效用时、麻醉药物使用量、麻醉持续时间)、患者各时间段[麻醉前(T_(1))、麻醉后10 min(T_(2))、手术开始时(T_(3))、手术结束后(T_(4))]血流动力学参数[心率(HR)、平均动脉压(MAP)],比较术后1 h、3 h、12 h、24 h患者疼痛状况[视觉模拟评分法(VAS评分)],记录因麻醉导致不良反应(心动过缓、呼吸困难、头晕、恶心呕吐、总不良反应)发生率。结果观察组麻醉阻滞起效用时、麻醉药物使用量分别为(3.84±1.23)min和(29.46±5.72)mL,均低于对照组的(6.17±1.79)min和(34.95±6.41)mL(P均<0.001);观察组麻醉持续时间为(324.31±19.57)min,长于对照组的(305.26±18.54)min(P<0.001);T_(1)时,血流动力学参数(HR、MAP)差异无统计学意义(P均>0.05),T_(2)~T_(4)时,观察组患者T_(2)、T_(3)、T_(4)各时段HR分别为(80.72±11.84)次/min、(82.13±8.54)次/min、(79.54±6.27)次/min,MAP分别为(91.26±12.27)mmHg(1 mmHg=0.133 kPa)、(97.71±8.45)mmHg、(90.67±7.54)mmHg均低于对照组T_(2)、T_(3)、T_(4)时段HR(88.69±12.08)次/min、(86.27±8.45)次/min、(86.27±8.45)次/min及T_(2)、T_(3)、T_(4)时段MAP(96.73±10.94)mmHg、(107.24±9.14)mmHg、(101.26±8.47)mmHg(P均<0.05),观察组总不良反应发生率为14.71%低于对照组总不良反应发生率35.29%(P<0.05)。结论电针复合臂丛神经阻滞对上肢骨折手术有着较好的麻醉效果,较高的安全性。Objective To explore the application value of electroacupuncture combined with brachial plexus block in surgical anesthesia of upper limb fracture.Methods A total of 136 patients undergoing anesthesia for upper limb fracture surgery in Nanyang Central Hospital from April 2018 to April 2021 were selected and divided into observation group and control group by random number table,with 68 cases in each group.The control group was given brachial plexus block anesthesia,and the observation group was given electroacupuncture combined with brachial plexus block anesthesia.The anesthesia status at operation(at what time anesthesia block took effect,the amount of anesthetic drugs used,and the duration of anesthesia),hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP)]at each time period[before anesthesia(T_(1)),10 min after anesthesia(T_(2)),at the beginning of surgery(T_(3)),and at the end of surgery(T_(4))]were compared between the two groups.The pain status of patients at 1 h,3 h,12 h and 24 h after surgery was compared[visual analogue scale(VAS score)],and the incidence of adverse reactions caused by anesthesia(bradycardia,dyspnea,dizziness,nausea and vomiting,and total adverse reactions)was recorded.Results The amount of time that anesthesia took effect and the amount of anesthetic drugs used in the observation group were(3.84±1.23)min and(29.46±5.72)mL,respectively,which were lower than those in the control group(6.17±1.79)min and(34.95±6.41)mL(P<0.05).The duration of anesthesia in the observation group was(324.31±19.57)min,longer than(305.26±18.54)min in the control group(P<0.05).At T_(1),there was no significant difference in hemodynamic parameters(HR and MAP)(P>0.05).At T_(2)~T_(4),HR of the observation group at T_(2),T_(3) and T_(4) were(80.72±11.84)times/min,(82.13±8.54)times/min,(79.54±6.27)times/min,respectively.MAP values were(91.26±12.27)mmHg(1 mmHg=0.133 kPa),(97.71±8.45)mmHg,(90.67±7.54)mmHg,which were lower than those in the control group(88.69±12.08)times/min,(86.27±8.45)time

关 键 词：电针 神经臂丛阻滞麻醉 上肢骨折手术 血流动力学 不良反应 

分 类 号：R614[医药卫生—麻醉学]