小儿断指再植手术神经刺激仪定位臂丛神经阻滞的麻醉效果

目的比较用外周神经刺激仪定位臂丛神经阻滞与传统针刺定位臂丛神经阻滞用于小儿断指再植手术的麻醉效果。方法将断指再植的小儿患者50例均等分为两组,均采用基础麻醉加腋路臂丛神经阻滞麻醉,Ⅰ组用神经刺激仪定位腋路臂丛神经阻滞。Ⅱ组采用传统的腋路臂丛神经阻滞。两组穿刺点均用两点法麻醉。神经阻滞药物为0.375%罗哌卡因(耐乐品0.75%)注射液,按3 mg/kg给药。完成阻滞后记录麻醉起效时间,作用效果,维持时间,术后并发症。结果在基础麻醉下阻滞起效时间比较无显著性差异,但阻滞成功率Ⅰ组显著高于Ⅱ组,阻滞维持时间Ⅰ组显著长于Ⅱ组(P<0.05)。结论小儿断指再植手术在基础麻醉下使用外周神经刺激仪,施行臂丛神经阻滞麻醉能较准确的实施,更加安全可靠。

Clinical application of brachial plexus block guided by peripheral nerve stimulator used in children replantation for broken finger

Objective To compare the clinical outcomes of brachial plexus block with and without the guidance of peripheral nerve stimulator in children replantation for broken finger.Methods The 50 cases children patients undergoing replantation for broken finger were divided into two groups,were all use basal anesthesia combined axillary brachial plexus block.The brachial plexus block was performed under the guidance of peripheral nerve stimulator in group Ⅰ,and with conventional technigue in group Ⅱ.Nerve block drugs were 0.375% ropivacaine;the onset duration,effect,the euration and post-operative complications were observed.Results The effect was stronger,the continous duration was longer,effective rate was higner in group Ⅰ than that in group Ⅱ,there was statistical differences(P<0.05).Conclusion Brachial plexus block can be improved by the guidance of peripheral nerve stimulator in children replantation for broken finger.