锁骨上臂丛神经阻滞麻醉用于小儿上肢手术的效果研究  

Study on the effect of supraclavicular brachial plexus block for upper extremity surgery in children

作　　者：庞欣杰 卢锦容 罗斌 黄天安[1] PANG Xin-jie;LU Jin-rong;LUO Bin(Department of Anesthesiology,Huaiji County People's Hospital,Zhaoqing 526400,China)

机构地区：[1]广东省怀集县人民医院麻醉科,526400

出　　处：《中国现代药物应用》2024年第4期105-107,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨小儿上肢手术中锁骨上臂丛神经阻滞麻醉的应用价值。方法56例行小儿上肢手术的患儿,用随机数字表法分为观察组和对照组,各28例。对照组行气管插管全身麻醉(全麻),观察组行锁骨上臂丛神经阻滞麻醉。比较两组患儿术前、切皮时、术中、手术结束时的生命体征指标及麻醉效果、麻醉不良反应发生率、麻醉起效时间、入睡时间、苏醒时间。结果观察组患儿在切皮时、术中、手术结束后的收缩压(SBP)、舒张压(DBP)、心率(HR)与对照组相比更加平稳,且手术结束时观察组患儿血氧饱和度(SpO2)(98.96±4.05)%明显高于对照组的(93.62±4.15)%,差异显著(P<0.05)。观察组患儿麻醉优良率96.43%高于对照组的78.57%,差异显著(P<0.05)。观察组麻醉不良反应发生率7.14%低于对照组的28.57%,差异显著(P<0.05)。观察组患儿的苏醒时间(7.25±1.38)min短于对照组的(31.14±4.16)min,差异显著(P<0.05)。结论小儿上肢手术中运用锁骨上臂丛神经阻滞麻醉可提高麻醉优良率,缩短患儿的苏醒时间,且麻醉安全性较高,因此,具备临床借鉴与推广的价值。Objective To explore the application value of supraclavicular brachial plexus block for upper extremity surgery in children.Methods 56 children who received upper limb surgery were divided into an observation group and a control group by random digital table method,with 28 cases in each group.The control group was anesthetized by general anesthesia with tracheal intubation,and the observation group was anesthetized by supraclavicular brachial plexus block.The vital signs indexes before surgery,at the time of skin incision,during surgery,and at the end of surgery,anesthesia effect,incidence of adverse reactions in anesthesia,onset time of anesthesia,sleep time and recovery time of the two groups were compared.Results The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)of the observation group were more stable than those of the control group at the time of incision,during surgery and at the end of surgery;SpO2 of(98.96±4.05)%in the observation group at the end of surgery was significantly higher than(93.62±4.15)%in the control group;there was significant difference(P<0.05).The excellent and good rate of anesthesia in the observation group was 96.43%,which was higher than 78.57%in the control group,and the difference was significant(P<0.05).The incidence of adverse reactions in anesthesia in the observation group was 7.14%,which was lower than 28.57%in the control group,and the difference was significant(P<0.05).The recovery time of(7.25±1.38)min in the observation group was shorter than(31.14±4.16)min in the control group,and the difference was significant(P<0.05).Conclusion Subclavian brachial plexus block anesthesia can improve the excellent and good rate of anesthesia,shorten the recovery time of children,and the safety of anesthesia is high.Therefore,it has the value of clinical reference and popularization.

关 键 词：小儿上肢手术 锁骨上臂丛神经阻滞麻醉 气管插管 全身麻醉 麻醉效果 

分 类 号：R726.1[医药卫生—儿科]