超声引导下臂丛神经阻滞复合喉罩浅全身麻醉在上肢骨折手术患儿中的应用效果  

Application effects of ultrasound-guided brachial plexus block combined with shallow general anesthesia by laryngeal mask in children undergoing upper limb fracture surgeries

作　　者：程世清 CHENG Shiqing(Department of Anesthesiology of Ningde Hospital of Traditional Chinese Medicine,Ningde 352100 Fujian,China)

机构地区：[1]宁德市中医院麻醉科,福建宁德352100

出　　处：《中国民康医学》2023年第16期60-63,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察超声引导下臂丛神经阻滞复合喉罩浅全身麻醉在上肢骨折手术患儿中的应用效果。方法:回顾性分析2021年5月至2022年6月该院收治的98例上肢骨折患儿的临床资料,按照术中麻醉方式不同将其分为对照组(48例)与观察组(50例)。两组均行复位内固定术治疗,对照组实施喉罩浅全身麻醉,观察组实施超声引导下臂丛神经阻滞复合喉罩浅全身麻醉。比较两组麻醉相关指标(麻醉起效时间、喉罩拔除时间、苏醒时间)水平,不同时间[麻醉前(T_(0))、置入喉罩时(T_(1))、拔除喉罩时(T_(2))]血流动力学指标[心率、平均动脉压(MAP)]水平,术前和术后1、3 d血清炎性因子[白细胞介素-1β(IL-1β)、IL-10、肿瘤坏死因子-α(TNF-α)]水平、应激指标[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]水平。结果:观察组喉罩拔除时间、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、MAP水平均高于T_(0)时,但观察组低于对照组,差异有统计学意义(P<0.05);术后1、3 d,两组血清IL-1β、IL-10、TNF-α、Cor、E、NE水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);两组麻醉起效时间比较,差异无统计学意义(P>0.05)。结论:超声引导下臂丛神经阻滞复合喉罩浅全身麻醉应用于上肢骨折手术患儿可缩短喉罩拔除时间和苏醒时间,稳定血流动力学指标水平,降低血清炎性因子、应激指标水平,效果优于单纯喉罩浅全身麻醉。Objective:To observe application effects of ultrasound-guided brachial plexus block combined with shallow general anesthesia by laryngeal mask in children undergoing upper limb fracture surgeries.Methods:The clinical data of 98 children undergone upper limb fractures admitted to this hospital from May 2021 to June 2022 were retrospectively analyzed.They were divided into control group(48 cases)and observation group(50 cases)according to different intraoperative anesthesia methods.Both groups were treated with reduction and internal fixation.The control group was given shallow general anesthesia by laryngeal mask,while the observation group was given ultrasound-guided brachial plexus block combined with shallow general anesthesia by laryngeal mask.The levels of anesthesia-related indexes(onset time of anesthesia,removal time of laryngeal mask,recovery time),the hemodynamic index levels[heart rate,mean arterial pressure(MAP)]at different time[before anesthesia(T_(0)),at the time of laryngeal mask insertion(T_(1)),at the time of laryngeal mask removal(T_(2))],and the levels of inflammatory factors[interleukin-1β(IL-1β),IL-10,tumor necrosis factor-α(TNF-α)]and stress indexes[epinephrine(E),norepinephrine(NE),cortisol(Cor)]before and 1,3 days after the surgery were compared between the two groups.Results:The removal time of laryngeal mask 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 rate and MAP levels of the two groups were higher than those at T_(0),but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).1 and 3 days after the surgery,the levels of IL-1β,IL-10,TNF-α,Cor,E and NE in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no signi

关 键 词：儿童 上肢骨折 手术 喉罩浅全身麻醉 超声引导 臂丛神经阻滞 血流动力学 

分 类 号：R683[医药卫生—骨科学]