臂丛神经阻滞辅助全静脉麻醉喉罩放置对尺桡骨双骨折患儿麻醉效果观察

Observation on the anesthesia effect of brachial plexus block assisted with total intravenous anesthesia with laryngeal mask in children with bilateral fractures of radius and ulna

目的:探究臂丛神经阻滞辅助全静脉麻醉喉罩放置对尺桡骨双骨折患儿术后苏醒时间及视觉模拟评分法(Visual analogue scoring,VAS)评分的影响。方法:选择月本院收治的60例尺桡骨双骨折患儿,根据治疗方案不同,分为对照组(全静脉麻醉喉罩放置)、观察组(全静脉麻醉喉罩放置+臂丛神经阻滞),各30例。比较术中镇静、术后恢复,并比较不同时刻(术后0.5 h、术后3 h、术后6 h、术后12 h)VAS评分、不同时刻(麻醉前(T_(0))、切皮即刻(T_(1))、术后30 min(T_(2))、术毕即刻(T_(3)))心率(Heart rate,HR)、收缩压、舒张压、术前和术后24 h应激反应指标(超氧化物歧化酶(Super oxide dismutase,SOD)、过氧化氢酶(Catalase,CAT)、皮质醇(Cortisol,Cor)、去甲肾上腺素(Norepinephrine,NE))。结果:观察组术中镇静、术后恢复均短于对照组(P<0.05);观察组不同时刻(0.5 h除外)VAS评分低于对照组(P<0.05);观察组不同时刻(T_(0)除外)HR、收缩压、舒张压均低于对照组(P<0.05);术后24 h观察组SOD、CAT均高于对照组,Cor、NE均低于常规组(P<0.05)。结论:臂丛神经阻滞辅助全静脉麻醉喉罩放置可缩短尺桡骨双骨折患儿术后苏醒时间,改善疼痛程度、生命体特征,降低应激反应。

Objective:To investigate the effect of brachial plexus block assisted with total intravenous anesthesia with laryngeal mask airway(LMA)placement on recovery time and visual analog scoring(VAS)in children with bilateral fractures of radius and ulna.Methods:60 children with bilateral fractures of radius and ulna who were admitted to our hospital in June were divided into two groups according to different treatment plans:the control group(total intravenous anesthesia LMA placement)and the observation group(total intravenous anesthesia LMA placement+brachial plexus block),with 30 cases in each group.Compare sedation during operation,recovery after operation,VAS score at different time(0.5 h,3 h,6 h,12 h after operation),heart rate(HR),systolic blood pressure,diastolic blood pressure,stress response index(superoxide dismutase(SOD)at different time(before anesthesia(T_(0)),immediately after skin incision(T_(1)),30 min after operation(T_(2)),immediately after operation(T_(3))Catalase(CAT),Cortisol(Cor),Norepinephrine(NE).Results:The sedation and postoperative recovery in the observation group were shorter than those in the control group(P<0.05);The VAS score of the observation group was lower than that of the control group at different times(except 0.5 h)(P<0.05);HR,systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group at different times(except T_(0))(P<0.05);24 hours after operation,SOD and CAT in the observation group were higher than those in the control group,while Cor and NE were lower than those in the conventional group(P<0.05).Conclusion:Brachial plexus block assisted with laryngeal mask airway placement under total intravenous anesthesia can shorten the recovery time of children with bilateral fractures of radius and ulna,improve the degree of pain,life characteristics,and reduce stress response.