摘要
目的研究瑞芬太尼泵注镇痛辅助臂丛神经阻滞麻醉对尺桡骨双骨折患儿术中血流动力学的影响。方法选取本院2014年6月至2018年10月收治的52例尺桡骨双骨折患儿作为研究对象,按照抽签法分为对照组(26例)和观察组(26例)。观察组采取瑞芬太尼泵注镇痛辅助臂丛神经阻滞麻醉,对照组采取氯胺酮静注镇痛辅助臂丛神经阻滞麻醉。比较两组臂丛穿刺前(T1)、切皮时(T2)、骨折复位时(T3)、手术结束时(T4)血流动力学[心率(HR)、舒张压(DBP)、收缩压(SBP)]、术中镇静(OAA/S)评分、术后恢复情况及不良反应发生情况。结果两组T1~T4时刻HR波动幅度无显著差异(P>0.05);观察组T1~T4时刻的DBP、SBP波动幅度小于对照组,差异显著(P<0.05);观察组术中OAA/S评分低于对照组,呼吸恢复时间、苏醒时间短于对照组,差异显著(P<0.05);与对照组不良反应发生率11.54%(3/26)相比,观察组7.69%(2/26)较低,但无显著差异(P>0.05)。结论瑞芬太尼泵注镇痛辅助臂丛神经阻滞麻醉应用于尺桡骨双骨折患儿,可维持术中血流动力学稳定,改善镇静效果,加快术后呼吸恢复及苏醒,且不良反应发生率低。
Objective To study the effect of remifentanil pump analgesia assisted brachial plexus block anesthesia on hemodynamics in children with ulna-radius double fracture.Methods 52 children with ulna and radius double fracture were selected from June 2014 to October 2018,and divided into control group(26 cases)and observation group(26 cases)according to the method of drawing lots.The observation group was given remifentanil pump analgesia assisted brachial plexus block anesthesia,the control group was given ketamine injection analgesia assisted brachial plexus block anesthesia.Before brachial plexus puncture(T1),during skin incision(T2),after fracture reduction(T3),at the end of operation(T4),heart rate(HR),diastolic pressure(DBP),systolic pressure(SBP),score of sedation during operation(OAA/S),postoperative recovery and adverse reactions were compared between the two groups.Results There was no significant difference in HR fluctuation at T1~T4 between the two groups(P>0.05),the amplitude of DBP and SBP in the observation group was smaller than that in the control group(P<0.05),the OAA/S score in the observation group was lower than that in the control group,the recovery time and recovery time of aspiration were shorter than that of Control Group(P<0.05),and the incidence of adverse reaction was lower(7.69%,2/26)than that of control group(11.54%,3/26),but there was no significant difference(P>0.05).Conclusion Remifentanil pump analgesia combined with brachial plexus block anesthesia in children with ulnar-radius fractures can maintain the stability of intraoperative hemodynamics,improve the sedation effect,accelerate the recovery of postoperative breathing and resuscitation,and reduce the incidence of adverse reactions.
作者
杨卫
刘钊
刘有才
陈志刚
YANG Wei;LIU Zhao;LIU Youcai;CHEN Zhigang(Department of Anesthesiology,Zhengzhou Second People's Hospital,Zhengzhou Henan 450005,China)
出处
《临床研究》
2020年第12期4-6,共3页
Clinical Research
