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超声显微镜引导下小儿臂丛神经阻滞麻醉的临床应用。

Clinical Application of Ultrasound Microscopy-Guided Pediatric Brachial Plexus Nerve Block Anesthesia.

机构信息

Department of Anesthesiology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, China.

出版信息

Contrast Media Mol Imaging. 2022 Jun 23;2022:3383898. doi: 10.1155/2022/3383898. eCollection 2022.

Abstract

In order to investigate the anesthetic effect and safety of the ultrasound-guided brachial plexus block in pediatric upper limb surgery, this study retrospectively analyzed the anesthetic effect of the ultrasound-guided brachial plexus block in pediatric upper limb surgery. From January 2016 to December 2017, 82 children undergoing upper limb surgery in hospital A were selected and randomly divided into two groups by the coin method, with 41 children in each group. Ultrasound-guided brachial plexus block anesthesia and conventional anatomic localization brachial plexus block anesthesia were performed. The anesthetic drug dosage of sensory block at anesthesia completion time and motor block at onset time was compared between the two groups; the one-time puncture success rate and incidence of anesthesia complications were compared between the two groups (local anesthesia poisoning, nerve injury, pneumothorax, hematoma, and phrenic nerve palsy). The results showed that the anesthesia completion time in the study group was slightly longer than that in the control group. The sensory and motor block occurred earlier in the study group than in the control group. Low doses of narcotic drugs are used. The one-time puncture success rate of the study group was higher than that of the control group. The incidence of anesthesia complications was lower than that of the control group. The one-time puncture success rate was 92.8% in the study group and 75.7% in the control group. Ultrasound-guided brachial plexus block anesthesia has a significant effect in pediatric upper limb surgery, which can improve the anesthetic effect and reduce the incidence of complications, and is worthy of clinical promotion.

摘要

为了探讨超声引导下臂丛神经阻滞在小儿上肢手术中的麻醉效果和安全性,本研究回顾性分析了超声引导下臂丛神经阻滞在小儿上肢手术中的麻醉效果。选取 2016 年 1 月至 2017 年 12 月在医院 A 行上肢手术的 82 例患儿,采用硬币法随机分为两组,每组 41 例。分别行超声引导下臂丛神经阻滞麻醉和常规解剖定位臂丛神经阻滞麻醉,比较两组患儿麻醉完成时感觉阻滞的麻醉药物用量和运动阻滞起效时间;比较两组患儿的一次性穿刺成功率和麻醉并发症发生率(局麻药中毒、神经损伤、气胸、血肿、膈神经麻痹)。结果显示,研究组麻醉完成时间略长于对照组,研究组感觉和运动阻滞出现时间早于对照组,使用低剂量麻醉药物,研究组一次性穿刺成功率高于对照组,麻醉并发症发生率低于对照组。研究组一次性穿刺成功率为 92.8%,对照组为 75.7%。超声引导下臂丛神经阻滞麻醉在小儿上肢手术中效果显著,能提高麻醉效果,降低并发症发生率,值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a723/9246567/39dec0983ae3/CMMI2022-3383898.001.jpg

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