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目的目的:探究在超声引导下地佐辛复合地塞米松对腋路臂丛神经阻滞在儿童急诊手外伤手术中运用效果,为临床提供有效依据。方法选择2014年2月至2015年10月在我院门诊急诊就诊的拟行手部外伤手术的儿童112例,按随机数表法将112例患者分为超声引导下地佐辛复合地塞米松经腋路臂丛神经阻滞麻醉组(观察组)和传统的腋路臂丛神经阻滞麻醉组(对照组),每组各56例,对其进行比较分析。结果两组患者在注入麻药后在5min、10min、15min后观察组桡神经的阻滞有效率要明显优于对照组,在注入麻醉药物10min、15min后观察组尺神经和正中神经的阻滞有效率也要明显优于对照组(P<0.05);观察组患者在麻醉起效时间、阻滞完全时间上均要明显短于对照组(P<0.05),在麻醉持续时间上观察组要明显长于对照组(P<0.05)。术后两组患者在6h、12h、18h、24h、48h VAS评分上,观察组要明显低于对照组(P<0.05)。结论在儿童上肢手术中利用超声引导下地佐辛复合地塞米松经腋路臂丛神经阻滞麻醉操作方便,成功率高,能够增强腋路臂丛神经阻滞的效果,且术后并发不良反应少,值得推广应用。
Objective: To investigate the effect of dezocine combined dexamethasone on the axillary brachial plexus block in children’s emergency hand trauma surgery guided by ultrasound, and provide an effective basis for clinical practice. Methods From February 2014 to October 2015 in our hospital outpatient emergency treatment of traumatic surgery in children 112 cases of hand, according to random number table 112 patients were divided into ultrasound-guided dezocine dexamethasone complex Axillary brachial plexus block anesthesia group (observation group) and traditional axillary brachial plexus block anesthesia group (control group), 56 cases in each group, and compared them. Results After the injection of anesthetic, the effective rate of the blockage of the radial nerve in the observation group after 5, 10 and 15 minutes was obviously better than that of the control group. After the injection of anesthetic drugs for 10 and 15 minutes, the blockage of the fascia and median nerve were observed (P <0.05). The observation group had significantly shorter time to complete anesthesia and complete blockade compared with the control group (P <0.05), and the duration of anesthesia was significantly longer in the observation group than in the control group Longer than the control group (P <0.05). The postoperative two groups of patients at 6h, 12h, 18h, 24h, 48h VAS score, the observation group was significantly lower than the control group (P <0.05). Conclusion Ultrasound-guided dezocine and dexamethasone anesthesia in axillary brachial plexus block in children with upper extremity operation is easy and convenient to operate. The success rate is high, which can enhance the effect of axillary brachial plexus block and adverse reactions after operation Less, it is worth promoting application.