超声引导下臂丛神经阻滞麻醉在危重患者上肢骨科手术中的应用效果

Application effect of ultrasound-guided brachial plexus block anesthesia in critical patients undergoing orthopaedic operation of upper extremity

目的探究超声引导下臂丛神经阻滞麻醉在危重患者上肢骨科手术中的应用效果。方法回顾性分析2018年1月至2018年12月我院收治的行上肢骨科手术的72例危重患者的临床资料,将患者根据麻醉方式不同分为对照组和观察组,每组36例。对照组采用盲探臂丛神经阻滞麻醉,观察组采用超声引导下臂丛神经阻滞麻醉。比较两组患者的麻醉效果。结果麻醉前、麻醉后30、60 min,两组患者平均动脉压、心率组间和组内比较,差异均无统计学意义(P>0.05);观察组完成阻滞时间、麻醉起效时间均明显短于对照组,镇痛维持时间明显长于对照组(P<0.05);麻醉后60 min,两组患者的Ramsay评分明显升高,且观察组显著高于对照组(P<0.05);观察组患者的麻醉总有效率显著高于对照组,并发症总发生率显著低于对照组(P<0.05)。结论超声引导下臂丛神经阻滞麻醉在危重患者上肢骨科手术中具有显著的麻醉镇静作用,安全可靠。

Objective To investigate the application effect of ultrasound-guided brachial plexus block anesthesia in critical patients undergoing or thopaedic operation of upper extremity.Methods The clinical data of 72 critical patients who underwent orthopaedic operation of upper extremity in our hospital from January 2018 to December 2018 were analyzed retrospectively.The patients were divided into control group and observation group according to different anesthesia methods,with 36 cases in each group.The control group was given blind exploration of brachial plexus block anesthesia,while the observation group was given ultrasound-guided brachial plexus block anesthesia.The anesthesia effects between the two groups were compared.Results There were no significant differences in the mean arterial pressure and heart rate between and in the two groups at 30 and 60 min after anesthesia(P>0.05).The complete block time and the onset time of anesthesia in the observation group were significantly shorter than those in the control group,and the duration of analgesia was significantly longer than that in the control group(P<0.05).At 60 min after anesthesia,the Ramsay scores in the two groups significantly increased,and that in the observation group was significantly higher than the control group(P<0.05).The total effective rate of anesthesia in the observation group was significantly higher than that in the control group,and the total incidence of complications was significantly lower than that in the control group(P<0.05).Conclusion Ultrasound-guided brachial plexus block anesthesia in critical patients undergoing orthopaedic operation of upper extremity has significant anesthetic and sedative effects,which is safe and reliable.