艾司氯胺酮联合臂丛麻醉方案在小儿上肢手术中的临床研究  

Clinical Study of Esketamine Combined with Brachial Plexus Anesthesia in Pediatric Upper Limb Surgery

作　　者：袁婉秋[1] 梁磊 周兵[1] YUAN Wanqiu;LIANG Lei;ZHOU Bing(Pingxiang People's Hospital of Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院,江西萍乡337000

出　　处：《中国医药指南》2022年第24期63-65,69,共4页Guide of China Medicine

基　　金：江西省卫生健康委科技计划(SKJP220218076)。

摘　　要：目的 探究在小儿上肢手术中艾司氯胺酮联合臂丛麻醉方案的临床应用效果。方法 本次研究在60例患儿中展开,选择2021年10月至2022年5月期间在本院实施上肢手术的儿童,运用奇偶数列法做随机分组,对照组(n=30)患儿接受喉罩全身麻醉联合臂丛麻醉,观察组(n=30)患儿给予艾司氯胺酮联合臂丛麻醉,对比麻醉效果及安全性。结果 切皮时、手术30 min、手术结束时观察组患儿的心率和平均动脉压波动较小,与对照组比较统计学意义成立(P <0.05)。观察组患儿切皮时、手术30 min、手术结束时OAA/S评分与对照组比较,统计学意义不成立(P> 0.05)。观察组患儿麻醉苏醒时间快于对照组,组间有显著差异(P <0.05)。结论 在小儿上肢手术中,艾司氯胺酮联合臂丛麻更醉方案具有良好的麻醉效果,镇静效果强,对血流动力学影响小,且比喉罩全身麻醉联合臂丛麻醉方案术后苏醒快,值得全方位推广应用。Objective To explore the clinical effect of esketamine combined with brachial plexus anesthesia in pediatric upper limb surgery.Methods This study was conducted in 60 children who underwent upper limb surgery in our hospital from October 2021 to May 2022.The children in the control group(n=30)received laryngeal mask general anesthesia combined with brachial plexus anesthesia,and the children in the observation group(n=30)received esketamine combined with brachial plexus anesthesia.Compare anesthetic effect and safety.Results The fluctuations of heart rate and mean arterial pressure in the observation group were significantly lower than those in the control group at the time of cut skin,surgery 30 min and end of surgery,with statistical significance(P<0.05).Compared with the control group,the OAA/S score of the observation group was not statistically significant,with statistical significance at the time of cut skin,surgery 30 min and end of surgery(P>0.05).The time of anesthesia recovery in the observation group was faster than that in the control group,and there was significant difference between the two groups(P<0.05).Conclusion Esketamine combined with brachial plexus anesthesia has a good anesthetic effect in pediatric upper limb surgery,with strong sedation effect,little influence on hemodynamics,fast postoperative recovery,which is worthy of comprehensive application.

关 键 词：艾司氯胺酮 臂丛麻醉 小儿上肢手术 

分 类 号：R614[医药卫生—麻醉学]