臂丛联合颈丛神经阻滞麻醉在肩部和上臂手术中的应用疗效观察

Observation on the application effect of brachial plexus combined with cervical plexus block anesthesia in shoulder and upper arm operation

目的分析臂丛+颈丛神经阻滞麻醉在肩部和上臂手术中的应用效果。方法选取2016年6月—2019年9月本院收治的70例肩部和上臂手术患者作为研究对象,随机平均分为对照组和观察组两组,每组各35例。对照组采纳臂丛神经阻滞麻醉,观察组采纳臂丛联合颈丛神经阻滞麻醉。对比两组不同时间段血流动力学指标、麻醉优良率、麻醉起效时间、麻醉维持时间、不良反应发生情况。结果观察组切皮后、缝合时心率、平均动脉压均明显比对照组低,观察组麻醉优良率(94.29%)明显高于对照组(74.29%),观察组麻醉起效时间、麻醉维持时间均明显比对照组短,差异均具有统计学意义(P<0.05)。观察组不良反应发生率(8.57%)与对照组(5.71%)比较,差异无统计学意义(P>0.05)。结论肩部和上臂手术患者实施臂丛+颈丛神经阻滞麻醉,可有效维持血流动力学稳定性,缩短麻醉起效时间,且不良反应发生率较低,值得借鉴。

Objective To analyze the application effect of brachial plexus and cervical plexus block anesthesia in shoulder and upper arm operation.Methods From June 2016 to September 2019, 70 patients underwent shoulder and upper arm operations were enrolled in our hospital. They were randomly divided into two groups on average. 35 patients in the control group received brachial plexus block anesthesia, and 35 patients in the observation group received brachial plexus combined with cervical plexus block anesthesia. The hemodynamic indexes, excellent rate of anesthesia, onset time and maintenance time of anesthesia and occurrence of adverse reactionswere compared between the two groups.Results The heart rate and average arterial pressure of the observation group were significantly lower than those of the control group after sectioning and suturing. The excellent rate of anesthesia in the observation group(94.29%) was significantly higher than that in the control group(74.29%). The onset time and maintenance time of anesthesia in the observation group were significantly shorter than those in the control group, with statistical significance(P<0.05). The incidence of adverse reactions in the observation group(8.57%) was higher than that in the control group(5.71%), however, the difference was not statistically significant(P>0.05).Conclusions Brachial plexus and cervical plexus block anesthesia could effectively maintain hemodynamic stability, shorten the onset time of anesthesia, and the incidence of adverse reactions is low, which is worth learning.