肌间沟法臂丛阻滞在学龄前儿童肱骨髁上骨折手术的效果

Effect of Intermuscular Point Brachial Plexus Block in Operation of Humeral Supracondylar Fracture in Preschool Child

目的:观察肌间沟法臂丛阻滞在学龄前小儿肱骨髁上骨折手术中的效果。方法:3岁～6岁肱骨髁上骨折择期手术病例60例:随机分为三组(各20例)。Ⅰ组(静脉全麻组)、Ⅱ组(低剂量臂丛组)、Ⅲ组(高剂量臂丛组)。Ⅰ组用氯胺酮,异丙酚静脉全麻。Ⅱ组(低剂量臂丛组):臂丛用1%利多卡因(含肾上腺素1/20万)0.5 ml/kg。Ⅲ组(高剂量臂丛组):臂丛用药量0.8 ml/kg。观察各组切皮前后、术中心率、血压,氯胺酮用量,术后苏醒时间。Ⅱ组、Ⅲ组不需追加氯胺酮的例数。结果:Ⅱ组、Ⅲ组比Ⅰ组苏醒快,心率、血压平稳。Ⅲ组比Ⅱ组追加氯胺酮例数少。结论:肌间沟入路臂丛神经阻滞可安全、有效应用于小儿肱骨髁上骨折手术。

Objective Observe the effect of intermuscular point brachial plexus nerve block in operation of humeral supracondylar fracture in preschoolchild.Mothods 60 cases from3-6 year patients of humeral supracondylar fracture are average random to three groups： Ⅰ group （.general intravenous anesthesia）：used by ketamine and diprivan. II group （low dose brachial plexus bloch）：intermuscular point brachial plexus block by lidocaine 0.5 ml/kg.Ⅲgroup（high dose brachial plexus block）. Ⅲgroup：the dose of lidocaine is 0.8 ml/kg.Observe HR,BP before the operation,just in cutting the skin.during the operation,the total dose of ketamine and the time of recovery in each group,and the sum of cases that keatamine not used additional in Ⅱ group ard Ⅲ group.Rosults The time of recovery is longer and the total dose of ketamine is larger in Ⅰ group.HR and BP stable in Ⅱ group and Ⅲ group.Consusion Intermuscular point brachial plexus block is safe and useful in the operation of humeral supracondylar fracture in preschool child.