超声引导下臂丛神经阻滞麻醉在肱骨干骨折内固定治疗患者中的应用效果

Application effect of ultrasound-guided brachial plexus block anesthesia in patients with humeral shaft fracture treated with internal fixation

目的 探讨超声引导下臂丛神经阻滞麻醉在肱骨干骨折内固定治疗患者中的应用效果。方法 选取2021年1月至2022年6月在我院进行肱骨干骨折内固定治疗的64例患者,采用随机数字表法将其分为试验组和对照组,各32例。试验组采用超声引导下臂丛神经阻滞麻醉,对照组采用传统解剖定位的盲探麻醉。比较两组的麻醉相关指标、血流动力学指标及不良反应发生情况。结果 试验组的麻醉起效时间短于对照组,麻醉药物用量、舒芬太尼用量少于对照组,差异具有统计学意义(P<0.05);两组的麻醉维持时间比较,差异无统计学意义(P>0.05)。麻醉操作结束时(T_(2)),试验组的收缩压(SBP)、舒张压(DBP)和心率(HR)高于麻醉前(T_(0)),差异具有统计学意义(P<0.05);T_(2)、麻醉后10 min(T_(3)),对照组的SBP、DBP、HR高于T_(0),差异具有统计学意义(P<0.05)。两组的恶心呕吐、呼吸抑制、Horner综合征发生率比较,差异无统计学意义(P>0.05);试验组的声音嘶哑发生率低于对照组,差异具有统计学意义(P<0.05)。结论 超声引导下臂丛神经阻滞可以满足肱骨干骨折内固定治疗的需求,且手术期间的麻醉效果比较稳定、血流动力学影响比较小。

Objective To explore the application effect of ultrasound-guided brachial plexus block anesthesia in patients with humeral shaft fracture treated with internal fixation.Methods A total of 64 patients underwent internal fixation treatment for humeral shaft fracture in our hospital from January 2021 to June 2022 were selected and randomly divided into experimental group and control group by random number table method,with 32 cases in each group.The experimental group used ultrasound-guided brachial plexus block anesthesia,while the control group used blind exploration anesthesia with traditional anatomical localization.The anesthesia related indicators,hemodynamic indicators and occurrence of adverse reactions between the two groups were compared.Results The anesthesia onset time of the experimental group was shorter than that of the control group,and the dosage of anesthetic drugs and sufentanil were less than those of the control group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the duration of anesthesia between the two groups(P>0.05).At the end of anesthesia(T_(2)),the systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)of the experimental group were higher than those before anesthesia(T_(0)),and the differences were statistically significant(P<0.05);at T_(2) and 10 min after anesthesia(T_(3)),the SBP,DBP and HR of the control group were higher than those of T_(0),and the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidences of nausea and vomiting,respiratory depression and Horner syndrome between the two groups(P>0.05);the incidence of hoarseness in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound-guided brachial plexus block anesthesia can meet the needs of internal fixation treatment for humeral shaft fracture,and the anesthesia effect during surgery is relatively stable with minimal hemodynamic impact.