论文部分内容阅读
目的观察与单纯气管插管全麻方法作比较喉罩全麻联合神经刺激仪辅助定位下臂丛神经阻滞在小儿上肢手术中的应用利弊,为小儿麻醉方法提供参考。方法选择美国麻醉师协会(ASA)评分Ⅰ-Ⅱ级,上肢手术患儿46例,随机分为两组:喉罩复合神经阻滞组(L组,23例)和气管插管组(T组,23例)。分别记录两组患儿麻醉前(T0)、插喉罩或气管导管时(T1)、拔喉罩或气管导管时(T2)、的MAP、HR、Sp02;并记录两组患儿术后疼痛、停药后苏醒时间、苏醒时躁动及术后嗜睡发生情况。结果两组患儿麻醉前(T0)的MAP、HR、Sp02值相比较差异无统计学意义(P>0.05);而在插喉罩或气管导管时(T1)、拔喉罩或气管导管时(T2),L组的MAP、HR低于T组,差异有统计学意义(P<0.05),L组的术后疼痛评分(VAS)低于T组,差异有统计学意义(P<0.05),停药后苏醒时间短于T组,差异有统计学意义(P<0.05),苏醒时躁动及术后嗜睡发生率明显低于T组,差异有统计学意义(P<0.05)。结论喉罩全麻联合神经刺激仪辅助定位下臂丛神经阻滞在小儿上肢手术中循环系统稳定,术后疼痛明显降低,苏醒质量高,不良反应小,值得临床推广。
Objective To observe the advantages and disadvantages of using general anesthesia with tracheal intubation and laryngeal mask general anesthesia combined with neurostimulation to locate the inferior brachial plexus block in pediatric upper limb surgery and provide reference for pediatric anesthesia. Methods The American Society of Anesthesiologists (ASA) grade Ⅰ-Ⅱ and 46 cases of upper limb surgery were randomly divided into two groups: laryngeal mask nerve block group (group L, 23 cases) and tracheal intubation group (group T) , 23 cases). The MAP, HR and Sp02 of two groups were recorded before anesthesia (T0), laryngeal mask or endotracheal tube (T1) and laryngeal mask or endotracheal tube (T2) respectively. The postoperative pain , Wake-up time after withdrawal, restlessness and postoperative sleepiness when awake. Results There was no significant difference in MAP, HR and Sp02 between the two groups before anesthesia (P> 0.05). However, when the laryngeal mask or endotracheal tube was inserted (T1) and the laryngeal mask or endotracheal tube was pulled (P <0.05). The postoperative pain score (VAS) in group L was lower than that in group T (P <0.05), and the difference was statistically significant (P <0.05) ), The recovery time after stopping was shorter than that of T group, the difference was statistically significant (P <0.05), and the incidence of restlessness and postoperative sleepiness was significantly lower than that of T group (P <0.05). Conclusion Laryngeal mask anesthesia combined with neurostimulator assisted positioning of the lower brachial plexus block in pediatric upper limb surgery circulatory system is stable, postoperative pain was significantly reduced, high quality of recovery, adverse reactions, worthy of clinical promotion.