全身麻醉改善上肢骨折复位手术患者术后舒适度研究

General Anesthesia Improve Postoperative Comfort of Patients with Upper Limb Fracture Fixation

目的寻找更有利于提高上肢骨折复位手术患者术后恢复期舒适度的麻醉方法。方法将拟行上肢骨折复位手术的患者随机分配到全身麻醉组(GA)和臂丛神经阻滞组(BB组),每组25例,评估患者术后疼痛,术后睡眠情况,对比术前、术后心境状态,观察术后镇痛药物使用以及术后并发症发生情况等。结果两组术后12小时内NRS疼痛评分均低于4分;GA组术后14~24 h疼痛评分和术后补救镇痛药物吗啡的使用剂量均低于BB组(P<0.05),且无爆发痛(术后12~14 h BB组患者出现爆发痛)与本体感觉消失的不适感,术后当晚睡眠质量也优于BB组(P<0.05)。结论与接受臂丛神经阻滞患者相比,接受全身麻醉的患者行上肢骨折复位手术术后舒适度更高。

Objective To find an anesthesia method which is more helpful to improve the comfort level of patients with upper limb fracture fixation.Methods patients who were to undergo fixation surgery for upper limb fractures were randomly assigned to the general anesthesia group(GA)and brachial plexus block group(BB),with 25 cases in each group.Postoperative pain and postoperative sleep were evaluated,preoperative and postoperative mood were compared,and postoperative analgesic drug use and postoperative complications were observed.Results The NRS pain score in both groups was lower than 3.The pain score and the dose of postoperative relief analgesic morphine in the GA group were both lower than those in the BB group at 14-24 hours after surgery(P<0.05),and there was no discomfort of rebound pain and loss of proprioception,and the sleep quality on the night after surgery was also better than that in the BB group(P<0.05).Conclusion compared with patients receiving brachial plexus block,patients receiving general anesthesia have higher comfort after fixation surgery for upper limb fracture.