髂筋膜阻滞联合瑞芬太尼喉罩全麻在小儿股骨骨折手术中的应用  

Application of Iliofascial Block Combined with Remifentanil Laryngeal Mask General Anesthesia in Pediatric Femur Fracture Surgery

作　　者：梁家新 吕广华 叶贵光 莫振科 罗萍 LIANG Jiaxin;LYU Guanghua;YE Guiguang;MO Zhenke;LUO Ping(Yulin Orthopedic Hospital of Integrated Chinese and Western Medicine,Yulin,Guangxi Zhuang Autonomous Region,537000 China)

机构地区：[1]玉林市中西医结合骨科医院,广西玉林537000

出　　处：《中外医疗》2024年第5期10-14,共5页China & Foreign Medical Treatment

基　　金：玉林市科学研究与技术开发计划项目(玉市科20212227)。

摘　　要：目的研究髂筋膜阻滞与瑞芬太尼喉罩全麻联合应用在股骨骨折患儿手术中的作用。方法简单随机选取2021年11月—2023年1月玉林市中西医结合骨科医院收治的70例股骨骨折手术患儿为研究对象,依托随机抽签法分为对照组与观察组,各35例。对照组应用气管插管全身麻醉,观察组应用髂筋膜阻滞联合瑞芬太尼喉罩全麻。记录并分析各时间点两组的平均动脉压(Mean Arterial Pressure,MAP)、心率(Heart Rate,HR)、视觉模拟量表(Visual Analogue Scale,VAS)评分、麻醉药物用量、清醒时间、麻醉后监测治疗室(Postanesthesia Care Unit,PACU)转出时间及麻醉不良反应发生率情况。结果T0时,两组MAP及HR比较,差异无统计学意义(P均>0.05);T1、T7时,观察组MAP分别为(93.56±9.50)mmHg、(91.34±9.32)mmHg,均低于对照组,HR分别为(78.42±9.36)mmHg、(78.12±9.02)mmHg,均小于对照组,差异有统计学意义(P均<0.05)。V0、V7时,观察组的VAS评分分别为(5.45±1.02)分、(1.65±0.38)分,均低于对照组,差异有统计学意义(P均<0.05)。观察组瑞芬太尼总用量为(1.02±0.25)mg,丙泊酚总用量为(245.70±56.24)mg,均低于对照组,清醒时间为(15.54±3.62)min,转出PACU转出时间为(35.76±4.88)min,均短于对照组,差异有统计学意义(P均<0.05)。观察组麻醉不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论髂筋膜阻滞中联合瑞芬太尼喉罩全麻在小儿股骨骨折患儿手术中的作用显著,有助于稳定血流动力学,减少麻醉药物使用,缓解术后疼痛,加速术后恢复,安全性较高。Objective To study the effect of iliofascial block combined with remifentanil laryngeal mask general anesthesia in the operation of children with femoral fracture.Methods Seventy pediatric patients with femoral fractures who underwent surgery at Yulin Integrated Traditional Chinese and Western Medicine Orthopedic Hospital from November 2021 to January 2023 were simple randomly selected as the research subjects.They were randomly divided into a control group and an observation group,with 35 cases in each group,using a random drawing method.The control group received general anesthesia with tracheal intubation,while the observation group received iliac fascia block combined with remifentanil laryngeal mask anesthesia.Recorded and analyzed the mean arterial pressure(MAP),heart rate(HR),Visual Analog Scale(VAS)scores,anesthetic dosage,wakefulness time,post anesthesia care unit(PACU)exit time,and incidence of adverse anesthesia reactions for both groups at each time point.Results At T0,there was no statistically significant difference in MAP and HR between the two groups(both P>0.05).At T1 and T7,the MAP values of the observation group were(93.56±9.50)mmHg and(91.34±9.32)mmHg,respectively,which were lower than those of the control group,the HR values were(78.42±9.36)mmHg and(78.12±9.02)mmHg,respectively,which were lower than those of the control group,and the differences were statistically significant(both P<0.05).At V0 and V7,the VAS scores of the observation group were(5.45±1.02)points and(1.65±0.38)points,respectively,which were lower than those of the control group,and the differences were statistically significant(both P<0.05).The total dosage of remifentanil and propofol in the observation group were(1.02±0.25)mg and(245.70±56.24)mg,both of which were lower than those in the control group,the wakefulness time was(15.54±3.62)min and the time to transfer out of PACU was(35.76±4.88)min,which were shorter than those in the control group,and the differences were statistically significant(all P<0.05).The inc

关 键 词：髂筋膜阻滞 瑞芬太尼 喉罩全麻 小儿 股骨骨折 

分 类 号：R5[医药卫生—内科学]