神经阻滞联合喉罩保留自主呼吸全麻在小儿断指再植手术中的应用效果

目的 探讨神经阻滞联合喉罩保留自主呼吸全麻与神经阻滞联合基础麻醉在小儿断指再植术中的应用效果.方法 选择2013年8月-2016年8月行断指再植手术的患儿60例,根据麻醉方法分为观察组和对照组,每组30例.观察组实行神经阻滞联合喉罩保留自主呼吸全麻方案,对照组采用神经阻滞联合基础麻醉方案.记录2组麻醉前、插入气管导管或置入喉罩时、麻醉后心率、平均动脉压(MAP)和血氧饱和度(SpO2),观察2组疼痛情况和术后苏醒时间及不良反应情况.结果 观察组置入喉罩和麻醉后心率高于麻醉前,对照组插入气管导管和麻醉后HR、MAP均高于麻醉前(P＜0.05);观察组置入喉罩和麻醉后心率、MAP低于对照组(P＜0.05);观察组视觉模拟疼痛评分和不良反应发生率低于对照组,苏醒时间和不良反应消失时间短于对照组(P＜0.05).结论 神经阻滞联合喉罩保留自主呼吸全麻应用于断指再植术中镇痛效果较好,术后不良反应消失快.

Effect of Nerve Block Combined with LMA during General Anesthesia in Application of Replantation of Amputated Finger Surgery for Children

Objective To investigate effect of nerve block combined with laryngeal mask airway (LMA) during general anesthesia in application of replantation of amputated finger surgery for children.Methods A total of 60 children undergoing replantation of amputated finger surgery admitted during August 2013 and August 2016 were divided into observation group and control group (n =30 for each group) according to different anesthesia methods.Observation group was treated with nerve block combined with LMA during general anesthesia,while control group was treated with nerve block combined with basal anesthesia.Values of heart rate (HR),mean arterial pressure (MAP) and blood oxygen saturation (SpO2) were recorded before anesthesia,at the time of tracheal intubation or LMA insertion and after anesthesia in two groups.Pain conditions,postoperative awakening time and incidence rates of complications were observed.Results HR levels at the time of LMA insertion and after anesthesia were significantly higher than those before anesthesia in observation group (P ＜ 0.05);in control group,HR and MAP levels at the time of tracheal intubation and after anesthesia were significantly higher than those before anesthesia (P ＜ 0.05).In observation group,HR and MAP levels at the time of LMA insertion and after anesthesia were significantly higher than those in control group (P ＜ 0.05);visual analogue scales (VAS) score and incidence rate of adverse reactions were significantly lower,while postoperative awakening time and disappearance time of adverse reactions were significantly shorter than those in control group (P ＜ 0.05).Conclusion Nerve block combined with laryngeal mask airway during general anesthesia in application of replantation of amputated finger surgery for children can achieve good analgesia effect with short disappearance time of adverse reactions.