臂丛神经阻滞联合喉罩全身麻醉在尺桡骨骨折患儿手术中的应用效果  

Application effects of brachial plexus block combined with laryngeal mask general anesthesia in children with ulna and radius fracture surgeries

作　　者：张国华 ZHANG Guohua(Department of Anesthesiology of Xiayi County Second People’s Hospital,Xiayi 476400 Henan,China)

机构地区：[1]夏邑县第二人民医院麻醉科,河南夏邑476400

出　　处：《中国民康医学》2022年第18期47-49,53,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察臂丛神经阻滞联合喉罩全身麻醉在尺桡骨骨折患儿手术中的应用效果。方法:回顾性分析2019年10月至2020年12月该院收治的94例行手术治疗尺桡骨骨折患儿的临床资料,根据麻醉方案不同将其分为对照组与观察组各47例。对照组采用喉罩全身麻醉,观察组在对照组基础上联合臂丛神经阻滞,比较两组麻醉起效时间、自主呼吸恢复时间、苏醒时间、不同时间点[麻醉前(T_(0))、骨折复位时(T_(1))、手术结束时(T_(2))]血流动力学指标水平、术后6 h镇静效果(Ramsay)评分、疼痛程度[疼痛行为量表(FLACC)]评分和不良反应发生率。结果:观察组麻醉起效时间、自主呼吸恢复时间、苏醒时间均短于对照组,差异有统计学意义(P<0.05);T_(1)、T_(2)时,两组心率均低于T_(0)时,但组间比较,差异无统计学意义(P>0.05);两组舒张压、收缩压均低于T_(0)时,但观察组高于对照组,差异有统计学意义(P<0.05);术后6 h,观察组Ramsay评分高于对照组,FLACC评分低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:臂丛神经阻滞联合喉罩全身麻醉应用于尺桡骨骨折患儿手术可缩短麻醉起效时间、自主呼吸恢复时间、苏醒时间,降低FLACC评分,以及提高Ramsay评分,其效果优于单纯喉罩全身麻醉。Objective:To observe application effects of brachial plexus block combined with laryngeal mask general anesthesia in children with ulna and radius fracture surgeries.Methods:The clinical data of 94 children with ulna and radius fractures who were treated in this hospital from October 2019 to December 2020 were retrospectively analyzed,and they were divided into control group and observation group according to different anesthesia schemes,47 cases in each group.The control group was given laryngeal mask general anesthesia,while the observation group was given brachial plexus block on the basis of that of the control group.The onset time of anesthesia,the spontaneous breathing recovery time,the recovery time,the hemodynamic index levels at different time points[before anesthesia(T_(0)),at the time of fracture reduction(T_(1)),at the end of surgery(T_(2))],the postoperative 6 h sedation effect(Ramsay)score,the pain severity[pain behavior scale(FLACC)]score,and incidence of adverse reactions were compared between the two groups.Results:The onset time of anesthesia,the spontaneous breathing recovery time,and the recovery time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).At T_(1) and T_(2),the heart rates of the two groups were lower than those at T_(0),but there was no significant difference between the two groups(P>0.05).The diastolic blood pressure and the systolic blood pressure of the two groups were lower than those at T_(0),but those of the observation group were higher than those of the control group,and the difference=were statistically significant(P<0.05).6 h after operation,the Ramsay score of the observation group was higher than that of the control group,the FLACC score was lower than that of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Brachial plexus block combined wi

关 键 词：喉罩全身麻醉 臂丛神经阻滞 患儿 尺桡骨骨折 FLACC评分 RAMSAY评分 不良反应 

分 类 号：R614[医药卫生—麻醉学]