摘要
目的探讨酮咯酸氨丁三醇辅助罗哌卡因臂丛神经阻滞在儿童桡尺骨手术中的应用效果。方法选取2018年6月至2021年6月赣州市中医院收治的106例桡尺骨折患儿为研究对象,采用随机抽签法分为观察组(53例)与对照组(53例)。两组患者均进行桡尺骨折复位固定术,对照组行罗哌卡因臂丛神经阻滞麻醉,观察组在对照组基础上辅助应用酮咯酸氨丁三醇。比较两组患儿的血流动力学指标、术后镇痛效果、应激反应指标、生活质量评分及不良反应总发生率。结果观察组治疗后平均动脉压、心率、血氧饱和度均高于对照组,差异有统计学意义(P<0.05)。观察组在术后2、6、12、24 h的视觉模拟评分法评分均低于对照组,差异有统计学意义(P<0.05)。观察组患儿术后24 h的C反应蛋白、皮质醇、去甲肾上腺素水平均低于对照组,差异有统计学意义(P<0.05)。术后观察组患儿的生活质量各项评分均高于对照组,差异有统计学意义(P<0.05)。观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论酮咯酸氨丁三醇辅助罗哌卡因臂丛神经阻滞在儿童桡尺骨手术中的应用效果良好,能够维持患儿血压、心率、血氧饱和度的稳定状态,降低患儿的术后疼痛感,改善应激反应状态,提高患儿生活质量,治疗安全性良好,临床值得应用。
Objective To investigate the effect of Ketorolac Tromethamine assisted Ropivacaine brachial plexus block in children′s radius and ulna surgery.Methods A total of 106 children with radiulnar fracture admitted to Ganzhou Hospital of Traditional Chinese Medicine from June 2018 to June 2021 were selected as the study subjects,and randomly divided into observation group(n=53)and control group(n=53)by drawing lots.Both groups were treated with reduction and fixation of radioulnar fracture.The control group received brachial plexus block anesthesia with Ropivacaine,and the observation group was assisted with Ketorolac Tromethamine on the basis of the control group.The hemodynamic indexes,postoperative analgesic effect,stress response index level,quality of life score and the total incidence of adverse reactions were compared between the two groups.Results The mean arterial pressure,heart rate and blood oxygen saturation in observation group were higher than those in control group,the differences were statistically significant(P<0.05).At 2,6,12 and 24 h postoperatively,the visual analogue scores of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).The levels of C-reactive protein,cortisol and norepinephrine in observation group at 24 h after operation were lower than those in control group,the differences were statistically significant(P<0.05).The scores of postoperative quality of life in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The total incidence of adr in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Ketorolac Tromethamine assisted brachial plexus block with Ropivacaine has a good effect in children′s radial and ulnar surgery,which can maintain the stable state of blood pressure,heart rate and oxygen saturation,reduce postoperative pain,improve stress response,and improve the quality of life of children,with good safety,which can be recommended in clinical practice.
作者
赖建鸿
龙燕
曾凡英
LAI Jianhong;LONG Yan;ZENG Fanying(Department of Anesthesiology,Ganzhou Hospital of Traditional Chinese Medicine,Jiangxi Province,Ganzhou 341000,China;Department of Anesthesiology,Ganzhou People′s Hospital,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
CAS
2022年第7期93-97,共5页
China Modern Medicine
基金
江西省赣州市指导性科技计划任务(GZ2017ZSF306)。
关键词
桡尺骨折
手术治疗
臂丛神经阻滞
罗哌卡因
酮咯酸氨丁三醇
应用效果
应激反应
Fracture of radius and ulna
Surgical treatment
Brachial plexus block
Ropivacaine
Ketorolac Tromethamine
Application effect
Stress response