超声联合神经刺激器臂丛神经阻滞对行肱骨髁上骨折手术患儿的镇痛效果及对其血流动力学的影响分析  

Analgesic effect and hemodynamic influence of ultrasound combined neurostimulator brachial plexus block in children underwent supracondylar humeral fractures surgery

作　　者：冯旭[1] 姜锋[1] 吴显捷[1] FENG Xu;JIANG Feng;WU Xian-jie(Department of Anesthesiology,Dandong Central Hospital,Dandong 118002,Liaoning,China)

机构地区：[1]丹东市中心医院麻醉科,辽宁丹东118002

出　　处：《生物医学工程与临床》2021年第6期698-701,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨超声联合神经刺激器臂丛神经阻滞对行肱骨髁上骨折手术患儿的镇痛效果及对其血流动力学的影响。方法选择丹东市中心医院收治的肱骨髁上骨折患儿83例,其中男性66例,女性17例;年龄5~9岁,平均年龄6.8岁;体质量7.2~10.9 kg,平均体质量9.2 kg。根据术中臂丛神经阻滞方式的差异将其分为2组。其中研究组40例,采用超声联合神经刺激器臂丛神经阻滞治疗;对照组43例,采用单纯神经刺激器臂丛神经阻滞治疗。比较两组患儿的镇痛效果、血流动力学[舒张末期速度(EDV)、收缩期峰速度(PSV)、搏动指数(PI)、时间平均峰值流速(TAMAX)、阻力指数(RI)及血流量(Q)]变化等差异。结果术后,研究组麻醉优良率显著高于对照组(95%vs 76.8%;P<0.05);神经阻滞0.5 h后,除PSV外,研究组其他血流动力学指标均较对照组改善明显(P<0.05);术后1 d,研究组患儿的视觉模拟量表(VAS)评分显著低于对照组(P<0.05);术后,研究组并发症总发生率显著低于对照组(5.0%vs 23.3%;P<0.05)。结论超声联合神经刺激器臂丛神经阻滞对行肱骨髁上骨折手术患儿的镇痛效果更佳,同时还可改善患儿的上肢血液循环情况,并降低不良反应发生率,值得临床推广应用。Objective To investigate the analgesic effect and hemodynamic influence of ultrasound combined neurostimulator brachial plexus blockin children performed supracondylar humeral fractures surgery.Methods A total of 83 children with supracondylar humeral fractures were enrolled,which included 66 males and 17 females,aged 5-9 years old with mean age of 6.8 years old;body mass was 7.2-10.9 kg with mean body mass of 9.2 kg.According to intraoperative brachial plexus block method,they were divided into study group(n=40,performed ultrasound combined neurostimulator brachial plexus block)and control group(n=43,performed single nerve stimulator brachial plexus block).The analgesia effect,hemodynamics[end diastolic velocity(EDV),peak systolic velocity(PSV),pulsatility index(PI),time average maxmum velocity(TAMAX),resistance index(RI)and blood flow(Q)]between 2 groups were compared.Results After operation,the superior rate of anesthesia in study group was significantly higher than that in control group(95.0%vs 76.8%;P<0.05);0.5-hour post nerve block,except for PSV,hemodynamic indicators in study group were significantly improved than that in control group(P<0.05);1-day after operation,the visual analog scale(VAS)score in study group was significantly lower than that in control group(P<0.05);the total incidence of postoperative complications in study group was significantly lower than that in control group(5.0%vs 23.3%;P<0.05).Conclusion It is demonstrated that ultrasound combined neurostimulator brachial plexus nerve block has better analgesic effect for surgery on children with supracondylar humeral fracture,and also improves blood circulation of the upper extremity and reduces adverse reactions,which is worthy of clinical application.

关 键 词：超声引导 神经刺激器 臂丛神经阻滞 肱骨髁上骨折 镇痛效果 血流动力学 

分 类 号：R726.1[医药卫生—儿科] R445.1[医药卫生—临床医学]