颈部硬膜外与连续臂丛阻滞两种麻醉方法在断指(肢)再植手术麻醉和术后镇痛的效果分析  

Analysis of the Efficacy of Two Anaesthetic Methods of Cervical Epidural Versus Continuousbrachial Plexus Block for Anaesthesia and Postoperative Analgesia in Digital(Limb)Reimplantation Surgery

作　　者：师军永 侯玲莉 付刚 孙文博 SHI Jun-yong;HOU Ling-li;FU Gang;SUN Wen-bo(Department of Anesthesiology,Hospital of the 83rd Army of PLA,Xinxiang 453000,Henan Province,China)

机构地区：[1]解放军第八十三集团军医院麻醉科,河南新乡453000

出　　处：《罕少疾病杂志》2025年第1期136-137,143,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的本次研究主要分析颈部硬膜外与连续臂丛阻滞两种麻醉方法在断指(肢)再植手术麻醉和术后镇痛的效果。方法采取2019年5月至2020年5月在我院进行断指再植手术的80名患者按随机数字的方法分为两组,即观察组和对照组,观察组使用连续臂丛阻滞的麻醉方法进行麻醉,比较两组之间不同麻醉方法的优缺点。检测两组麻醉前、手术后的血氧饱和度(SPO2)、患者血压指数(BP)、心律(HR)、心电图指数变化(ECG)的不良反应,并且测定的同时记录下患者的VAS评分、麻醉起效时间、感觉阻滞的完整程度、局部.性麻醉药以及辅助用药量。结果使用连续臂丛阻滞麻醉法的观察组,麻醉感觉阻滞的完善实践与起效时间明显快于使用颈部硬膜外麻醉法的对照组(P<005)。而局部性麻醉用药量两组对比结果并无明显差异。结论为断指(肢)再植手术患者选用臂丛连续阻滞的麻醉法进行麻醉后,麻醉效果起效快、镇痛也相对较为完善,并且便于操作,可起到连续阻滞的作用,对身体机能循环、呼吸系统功能产生的影响较小,且在临床治疗中并未发生并发症和不良反应。具有应用价值,值得全面推广。Objective This study mainly analyzed the effects of two anesthesia methods,epidural versus continuous brachial plexus block in the neck,anesthesia and postoperative analgesia in the surgery of digital(limb)reimplantation.Methods 80 patients who underwent index reimplantation surgery in our hospital from May 2019 to May 2020 were divided into two groups,namely,observation group and control group,according to the method of random number,the observation group was anaesthetized using the anaesthetic method of continuous brachial plexus block,and the advantages and disadvantages of different anaesthetic methods were compared between the two groups.The blood oxygen saturation(SpO2),blood pressure index(BP),heart rate(HR),and changes in electrocardiogram index(ECG)of the patients before and after the operation in both groups were detected,and the VAS score,onset time of anesthesia,the complete degree of sensory block,local anesthetics as well as the amount of auxiliary medication were recorded at the same time.Results the well established practice of sensory blockade with anesthesia onset was significantly faster in the observation group using continuous brachial plexus block anesthesia than in the control group using cervical epidural anesthesia(P<0.05).However,the amount of drugs used for local anesthesia did not differ significantly between the two groups.Conclusion after anaesthesia by continuous block of the brachial plexus was selected for patients undergoing digital(limb)reimplantation surgery,the onset of anaesthetic effect was rapid and analgesia relatively well established,and it was easy to operate,which can play the role of continuous block and has less effect on physical function circulation and respiratory function,and it did not cause complications and adverse effects in clinical treatment.Has an applied value and deserves comprehensive promotion.

关 键 词：颈部硬膜外 连续臂丛阻滞 断指(肢)再植 镇痛 

分 类 号：R614[医药卫生—麻醉学]