臂丛神经阻滞合七氟醚吸入麻醉应用于小儿上肢骨折术中对患儿心率及平均动脉压水平改善情况的影响  

The effect of brachial plexus block combined with sevoflurane inhalation anesthesia on improvement of heart rate and mean arterial pressure in children with upper limb fracture

作　　者：杨洋 YANG Yang(Department of Anesthesiology,Dawanglu Emergency Rescue Hospital,Chaoyang District,Beijing,100020,China)

机构地区：[1]北京市朝阳区大望路急诊抢救医院麻醉科,北京100020

出　　处：《当代医学》2024年第17期40-44,共5页Contemporary Medicine

摘　　要：目的探讨臂丛神经阻滞合七氟醚吸入麻醉应用于小儿上肢骨折术中对患儿心率(heart rate,HR)、平均动脉压(mean arterial pressure,MAP)水平改善情况的影响。方法选取2019年1月至2021年12月于北京市朝阳区大望路急诊抢救医院接受诊治的90例上肢骨折患儿作为研究对象,采用单双号分发法分为常规组与研究组,每组45例。常规组采用丙泊酚进行麻醉,研究组采用臂丛神经阻滞合七氟醚吸入麻醉。比较两组麻醉前后HR与MAP、躁动及寒颤发生情况、术后不同时间点疼痛程度[视觉模拟评分法(visual analogue scale,VAS)评分]、麻醉效果、舒适度及不良反应发生情况。结果麻醉后,研究组MAP、HR均高于常规组,差异有统计学意义(P<0.05)。研究组躁动发生率低于常规组,差异有统计学意义(P<0.05)。研究组麻醉诱导时间、苏醒时间均短于常规组,运动神经阻滞时间、感觉神经阻滞时间均长于常规组,差异有统计学意义(P<0.05)。研究组寒颤发生率低于常规组,差异有统计学意义(P<0.05)。术后1、6、12及24 h,研究组VAS评分均低于常规组,差异有统计学意义(P<0.05)。干预后,研究组环境舒适、心理舒适、麻醉舒适及生理舒适评分均高于常规组,差异有统计学意义(P<0.05)。研究组不良反应发生率低于常规组,差异有统计学意义(P<0.05)。结论上肢骨折患儿采用臂丛神经阻滞合七氟醚吸入进行麻醉干预,可有效降低患儿的躁动、寒颤、不良反应发生率及疼痛程度,并提升患儿的舒适度及麻醉效果,改善患儿的HR及MAP。Objective To investigate the effect of brachial plexus block combined with sevoflurane inhalation anesthesia on the improvement of heart rate(HR)and mean arterial pressure(MAP)in children with upper limb fracture.Methods 90 patients with upper limb fracture who were treated in Dawanglu Emergency Rescue Hospital,Chaoyang District,Beijing from January 2019 to December 2021 were selected as the study sub-jects,they were divided into the conventional group and the study group according to odd-even number distribution method,with 45 cases in each group.The conventional group was anesthetised with propofol,and the study group was anesthetised with brachial plexus block combined with sevoflurane inhalation.The HR and MAP levels before and after anesthesia,occurrence of agitation and chills,postoperative pain degree at different time points(visual analogue scale[VAS]scores),anesthesia effect,comfort and occurrence of adverse reactions were compared between the two groups.Results After anesthesia,the levels of MAP and HR in the study group were higher than those in the conventional group,and the differences were statistically significant(P<0.05).The incidence of agitation in the study group was lower than that in the conventional group,and the differ-ence was statistically significant(P<0.05).The anesthesia induction time and recovery time in the study group were shorter than those in the conven-tional group,and the motor nerve block time and sensory nerve block time were longer than those in the conventional group,and the differences were statistically significant(P<0.05).The incidence of chills in the study group was lower than that in the conventional group,and the difference was sta-tistically significant(P<0.05).At 1 h,6 h,12 h and 24 h after surgery,the VAS scores in the study group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).After intervention,the scores of environmental comfort,psychological comfort,an-esthetic comfort and physiological comfort in the

关 键 词：臂丛神经阻滞 七氟醚吸入麻醉 小儿上肢骨折 心率 平均动脉压 

分 类 号：R614[医药卫生—麻醉学] R68[医药卫生—外科学]