超声引导下锁骨上臂丛神经阻滞在重症老年患者上肢骨折手术麻醉中的应用体会  

Experience of ultrasound-guided supracclavian brachial plexus block in surgical anesthesia for severe elderly patients with upper limb fractures

作　　者：彭云红 张丽 邵徽亚 PENG Yunhong;ZHANG Li;SHAO Huiya(Department of Anesthesiology,the Third People's Hospital of Jingdezhen,Jiangxi,Jingdezhen,333000,China)

机构地区：[1]景德镇市第三人民医院麻醉科,江西景德镇333000

出　　处：《当代医学》2024年第1期23-26,共4页Contemporary Medicine

摘　　要：目的探讨超声引导下锁骨上臂丛神经阻滞麻醉配合上肢骨折手术治疗用于重症老年患者的效果。方法选取2020年4月至2022年4月于景德镇市第三人民医院进行上肢骨折手术治疗的100例重症老年患者作为研究对象,根据麻醉方法的不同分为研究组与常规组,每组50例。常规组给予常规臂丛神经阻滞麻醉,研究组给予超声引导下锁骨上臂丛神经阻滞麻醉。比较两组麻醉阻滞起效时间、平均动脉压、心率、术后视觉模拟评分法(VAS)评分、并发症发生率及不良反应发生率。结果研究组运动阻滞起效时间、感觉阻滞起效时间均短于常规组,差异有统计学意义(P<0.05)。术前(T0),两组平均动脉、心率比较差异无统计学意义;切皮(T1)、术后30 min(T2)、术毕(T3)时,研究组平均动脉压、心率均低于常规组,差异有统计学意义(P<0.05)。术前,两组VAS评分比较差异无统计学意义;术后2、6、12 h,研究组VAS评分均低于常规组,差异有统计学意义(P<0.05)。研究组并发症发生率、不良反应发生率均低于常规组,差异有统计学意义(P<0.05)。结论行上肢骨折手术治疗的重症老年患者于超声引导下进行锁骨上臂丛神经阻滞麻醉的效果更佳,具有起效快、疼痛轻、血流动力学稳定、并发症少、不良反应发生率低等优势,值得临床推广应用。Objective To explore the effect of ultrasound-guided supracclavian brachial plexus block in surgical anesthesia for severe elderly pa-tients with upper limb fractures.Methods A total of 100 elderly patients with severe upper limb fractures who underwent surgical treatment in the Third People's Hospital of Jingdezhen from April 2020 to April 2022 were selected as the study subjects,they were divided into the study group and the conventional group according to different anesthesia methods,with 50 cases in each group.The conventional group received conventional brachi-al plexus block anesthesia,and the study group received ultrasound-guided supracclavian brachial plexus block in surgical anesthesia.The onset time of anesthesia block,mean artery pressure,heart rate,postoperative visual analogue scale(VAS)score,incidence of complications and incidence of ad-verse reactions were compared between the two groups.Results The onset time of motor block and sensory block in the study group were shorter than those in the conventional group,and the differences were statistically significant(P<0.05).Before operation(T0),there were no significant dif-ferences in mean artery and heart rate between the two groups;at skin incision(T1),30 min after operation(T2)and the end of surgery(T3),the mean artery pressure and heart rate in the study group were lower than those in the conventional group,and the differences were statistically signifi-cant(P<0.05).Before operation,there was no significant difference in VAS score between the two groups;at 2,6 and 12 h after operation,the VAS scores in the study group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).The incidence of complications and adverse reactions in the study group were lower than those in the conventional group,and the differences were statistically sig-nificant(P<0.05).Conclusion Ultrasound-guided supracclavian brachial plexus block in surgical anesthesia is more effective in severe elderly pa-tients with upper limb

关 键 词：重症 老年 上肢骨折 超声 锁骨上臂丛神经阻滞 

分 类 号：R614[医药卫生—麻醉学]