神经刺激仪联合超声引导臂丛神经阻滞在小儿肱骨骨折中的应用  

Application of nerve stimulator combined with ultrasound-guided brachial plexus block in humerus fracture in children

作　　者：薛璋明 韩小东 XUE Zhang-ming;HAN Xiao-dong(Anesthesia and Operation Center,Xi'an International Medical Center Hospital,Xi'an 710100,Shaanxi,CHINA;School of Medicine,Yan'an University,Yan'an 716000,Shaanxi,CHINA)

机构地区：[1]西安国际医学中心医院麻醉手术中心,陕西西安710100 [2]延安大学医学院,陕西延安716000

出　　处：《海南医学》2022年第9期1158-1161,共4页Hainan Medical Journal

摘　　要：目的探讨神经刺激仪联合超声引导臂丛神经阻滞在小儿肱骨骨折中的应用效果,为临床小儿肱骨骨折患者麻醉提供参考。方法选择2019年9月至2021年4月于西安国际医学中心医院就诊治疗的156例肱骨骨折患儿为研究对象,采用随机数表法分为三组,每组52例。A组患儿采用神经刺激仪引导臂丛神经阻滞,B组患儿采用超声引导臂丛神经阻滞,C组采用神经刺激仪联合超声引导臂丛神经阻滞。比较三组患者不同时间点的平均动脉压(MAP)、心率(HR)的变化,同时比较三组患者的神经阻滞完成时间、麻醉起效时间、镇痛维持时间、麻醉效果及术中或术后并发症发生情况。结果三组患儿不同时间点的MAP和HR比较差异均无统计学意义(P>0.05);C组患儿的神经阻滞完成时间和麻醉起效时间分别为(10.45±2.93)min,(5.38±1.13)min,明显短于A组的(18.37±3.54)min、(9.13±2.24)min和B组的(12.16±2.87)min、(6.75±1.21)min,镇痛维持时间为(461.78±15.32)min,明显长于A组的(425.29±15.85)min和B组的(453.63±15.27)min,差异均有统计学意义(P<0.05);C组患儿的麻醉优良率为100.00%,明显高于A组的88.46%,差异有统计学意义(P<0.05),但与B组的98.08%比较差异无统计学意义(P>0.05);A组、B组及C组患儿的并发症发生率分别为9.62%、5.77%、3.85%,差异无统计学意义(P>0.05)。结论小儿肱骨骨折手术中应用神经刺激仪联合超声引导臂丛神经阻滞,可明显缩短患儿的神经阻滞完成时间和麻醉起效时间,延长镇痛维持时间,不影响血流动力学,且不增加并发症发生风险,安全性较高。Objective To explore the application effect of nerve stimulator combined with ultrasound-guided brachial plexus block in pediatric humeral fractures,and to provide reference for clinical anesthesia for pediatric humeral fractures.Methods A total of 156 children with humeral fractures who were treated at Xi'an International Medical Center Hospital from September 2019 to April 2021 were selected as the research objects.The patients were divided into three groups using a random number table method,with 52 patients in each group.Children in group A were guided by nerve stimulator for brachial plexus block;children in group B were guided by ultrasound for brachial plexus block;those in group C were guided by nerve stimulator and ultrasound for brachial plexus block.The mean arterial pressure(MAP)and heart rate of the three groups were observed at different time points,and the completion time of nerve block,the onset time of anesthesia,the duration of analgesia,the effect of anesthesia and the occurrence of intraoperative or postoperative complications were compared among the three groups.Results There was no significant difference in MAP and HR between the three groups at different time points(P>0.05).The completion time of nerve block and the onset time of anesthesia in group C were(10.45±2.93)min,(5.38±1.13)min,significantly shorter than(18.37±3.54)min,(9.13±2.24)min in group A and(12.16±2.87)min,(6.75±1.21)min in group B(P<0.05).The duration of analgesia in group C was(461.78±15.32)min,significantly longer than(425.29±15.85)min in group A and(453.63±15.27)min in group B(P<0.05).The excellent and good rate of anesthesia in group C was 100.00%,which was significantly higher than 88.46%in group A(P<0.05)but showed no statistically difference from 98.08%in group B(P>0.05).The complication rates of children in group A,group B,and group C were 9.62%,5.77%,and 3.85%,respectively,and there was no statistically significant difference(P>0.05).Conclusion Nerve stimulator combined with ultrasound-guided brachial plexu

关 键 词：神经刺激仪 超声 臂丛神经阻滞 小儿肱骨骨折 神经阻滞 麻醉 安全性 

分 类 号：R726.8[医药卫生—儿科]