臂丛复合瑞芬太尼静脉麻醉在小儿上肢手术中的应用

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。

The application of brachial plexus nerve block combined with remifentanil intravenous anesthesia used in the operation of children''''s arm

Objective:To observe the effect of brachial plexus nerves block(BPB) located by ground nerve stimulator combined with remifentanil intravenous anesthesia on hemodynamics and recovery of the operation in children's arm.Methods:After ketamine based anesthesia,45 children undergoing arm operation were randomly divided into there groups: the BPB combined with ketamine intravenous anesthesia(BK,n=15);Intratracheal general anesthesia(IGA)(G,n=15);BPB combined with remifentanil intravenous anesthesia(BF,n=15).Results:The hemodynamic parameters in group BF were more steadily than that in group BK during the operation(P<0.05).The recovery was faster and more steadily in group BF,which was obviously difference of group G and BK(P<0.05).Conclusion:Brachial plexus nerve block combined with remifentanil intravenous anesthesia used in the operation of children's arm can make the circulation more steadily and have no respiratory depression with quick resuscitation and higher satisfaction of parents and service providers.