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目的:观察周围神经刺激器辅助定位下臂丛神经阻滞复合瑞芬太尼静脉麻醉在小儿上肢手术中应用,评估对血流动力学的影响及术后恢复情况。方法:45例行上肢手术患儿氯胺酮基础麻醉后随机分为3组:臂丛神经阻滞复合氯胺酮静脉麻醉组(BK组,n=15);气管内插管全麻组(G组,n=15);臂丛神经阻滞复合瑞芬太尼静脉麻醉组(BF组,n=15)。结果:BF组麻醉过程血流动力学参数变化较G、BK组稳定(P<0.05);术后BF组患儿苏醒最快且平稳,与G、BK组比较有显著差异(P<0.05)。结论:臂丛神经阻滞复合瑞芬太尼静脉麻醉应用于小儿上肢手术呼吸循环稳定,术后苏醒更快,家长及医护人员满意度明显提高。
OBJECTIVE: To observe the application of peripheral nerve stimulator-assisted positioning of lower brachial plexus block and remifentanil intravenous anesthesia in pediatric upper limb surgery to assess the effect on hemodynamics and postoperative recovery. Methods: Forty-five children undergoing upper limb surgery were randomly divided into three groups: anesthesia with brachial plexus block combined with ketamine intravenous anesthesia (BK group, n = 15); tracheal intubation general anesthesia group (group G, n = 15); brachial plexus block remifentanil intravenous anesthesia group (BF group, n = 15). Results: The changes of hemodynamic parameters in BF group were more stable than those in G and BK groups (P <0.05). The recovery rate of BF group was the fastest and stable after operation, which was significantly different from that in G and BK groups (P <0.05) . Conclusion: The brachial plexus block combined with remifentanil intravenous anesthesia is used to stabilize respiration cycle of pediatric upper extremity surgery. The resuscitation is faster and the satisfaction of parents and medical staffs is obviously improved.