摘要
目的探讨超声引导小儿肌间沟臂丛神经阻滞的有效性和安全性。方法选择我院需行上肢手术的住院患儿80例,随机分成A、B两组,各40例,A组在超声引导下行臂丛神经阻滞;B组选用传统穿刺方法,依靠患儿体表解剖标志定位后穿刺行臂丛神经阻滞。记录并比较两组患儿的生命体征和初醒时间、术中氯胺酮追加剂量和例数、并发症、镇静程度和麻醉效果。结果两组患者年龄、性别、体质量、手术时间及神经阻滞操作时间比较差异均无统计学意义;除A组发生2例的霍纳氏综合征外,其余均未发生并发症;A组在超声定位下行肌间沟臂丛神经阻滞的麻醉效果明显优于B组(P<0.05);A组患儿氯胺酮用量较B组少,麻醉初醒时间较B组短,两组比较差异均有统计学意义(均P<0.05);A组神经阻滞并发症的发生率及术中切皮和缝皮时收缩压、舒张压、心率及呼吸均明显低于B组,差异均有统计学意义(均P<0.05)。结论超声引导小儿臂丛神经阻滞使麻醉更加安全,可减少儿童痛苦,不良反应少,而且操作方法简便易于掌握。
Objective To explore the efficacy and safety of brachial plexus block in children by the guidance of ultrasound.Methods Eighty patients receiving upper extremity surgery were randomly divided into two groups. Group A were guided by ultrasound（40 cases）,and group B were implemented by the traditional method（40 cases）,which was on the most obvious pulse of axillary artery in anatomy. The vital signs,awakening time,additional doses of ketamine,the patient numbers of additional anesthetic usage,complications,levels of sedation and anesthetic effects of the children patients were recorded.Results There were no significant differences in age,sex,weight,operation time and maintenance time between two groups.There were 2 patients suffered from Horner＇s Syndrome,and no other complications in group A and group B. There was better anesthesia effect in group A by ultrasound locatization compared with B group（P〈0.05）.There were more stable vital signs,shorter awakening time,less additional doses of ketamine,less complications,and higher levels of sedation and anesthetic effects in group A. Compared to group B,there were less nerve block complications in group A（P〈0.01）.Patients in B group had obivously higher systolic pressure,diastolic pressure,heart rate and respiration rate（all P〈0.05）.Conclusion The guidance of ultrasound in brachial plexus block is easy to learn and apply,showing more safer,less pain,less complications and more satisfactory effect than the traditional method.
出处
《临床超声医学杂志》
2016年第3期192-194,共3页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
小儿
臂丛
神经阻滞
Ultrasonography
Children
Brachial plexus
Nerve block
