超声引导下臂丛神经麻醉阻滞在小儿上肢手术中的应用观察

Application of Ultrasound-guided Brachial Plexus Nerve Block in Pediatric Upper Limb Surgery

目的探究超声引导下臂丛神经麻醉阻滞在小儿上肢手术中的应用效果。方法选取2019年3月至2021年3月本院需进行上肢手术治疗的患儿106例,按随机数字表法分为超声组50例和定位组56例,超声组在术前行超声引导下臂丛神经麻醉阻滞,定位组在术前行固定解剖定位臂丛神经麻醉阻滞,比较两组患儿术中生命体征、麻醉阻滞效果、麻醉相关指标及麻醉并发症差异。结果超声组术中心率(HR)、呼吸频率(RR)、平均脉动圧(MAP)及血氧浓度(SPO_(2))等各项生命体征无明显变化,差异无统计学意义(P>0.05),定位组术中HR、MAP明显低于术前(P<0.05);两组阻滞总有效率比较差异无统计学意义(P>0.05);超声组阻滞所用时间、起效时间明显短于定位组,但持续时间明显长于定位组(P<0.05),辅助麻醉药物用量明显低于定位组(P<0.05);超声组并发症总发生率明显低于定位组(P<0.05)。结论小儿上肢手术中行超声引导下臂丛神经麻醉阻滞麻醉效果好,患儿术中生命体征更稳定,可缩短麻醉起效速度,延长麻醉持续时间,减少辅助麻醉药物用量,有助于降低麻醉并发症发生率。

Objective To explore the application effect of ultrasound-guided brachial plexus nerve block in pediatric upper limb surgery.Methods 106 children scheduled to be treated with upper limb surgery were selected between March 2019 and March 2021,and divided into ultrasound group(50 cases)and positioning group(56 cases)according to random number table method.Children in the ultrasound group were given ultrasound-guided brachial plexus nerve block,while children in the positioning group were given brachial plexus nerve block under fixed anatomy positioning before surgery.Intraoperative vital signs,block effects,anesthesia-related indicators and complications were compared between the two groups.Results No significant changes in heart rate(HR),respiratory rate(RR),mean arterial pressure(MAP)and blood oxygen saturation(SPO_(2))were observed in the ultrasound group(P>0.05),but the HR and MAP of positioning group were significantly lower during surgery than before surgery(P<0.05).There was no statistically significant difference in the total effective rate of block between the two groups(P>0.05).The block time and onset time of the ultrasound group were significantly shorter than those of the positioning group,but the duration was significantly longer than that of the positioning group(P<0.05).The dosage of auxiliary anesthetics and the total incidence of complications in the ultrasound group were significantly lower than those in the positioning group(P<0.05).Conclusion Ultrasound-guided brachial plexus nerve block can achieve better effect in pediatric upper limb surgery,and the children’s vital signs during surgery are more stable.It can shorten the onset time of anesthesia,prolong the duration of anesthesia,and reduce the dosage of auxiliary anesthetics,which is conducive to lowering the incidence of complications.