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目的:结合临床实践经验,探讨氯胺酮联合臂丛神经阻滞麻醉在儿童上肢手术中的临床应用价值。方法:选择我院接受上肢手术患儿82例为研究对象,将患儿随机均分为氯胺酮组和氯胺酮联合臂丛神经阻滞组,手术中分别采用不同的麻醉方法,比较两组患儿麻醉前后的MAP、HR、SPO2变化、苏醒时间、以及不良反应情况的差别,探讨两种麻醉方法的有效性。结果:氯胺酮组苏醒所需时间明显多于氯胺酮联合臂丛神经阻滞组,后者苏醒较快。氯胺酮组麻醉前后,MAP、HR、SPO2变化较大,且差异有统计学意义。而氯胺酮联合臂丛神经阻滞组MAP、Hr、SPO2无大波动,前后差异无统计学意义。氯胺酮组患儿均有不同程度的不良反应出现,而氯胺酮联合臂丛神经阻滞组则较少,各种不良反应发生率比较,差异有统计学意义,后者低于前者。结论:小儿上肢手术用氯胺酮联合臂丛神经阻滞的方式麻醉,麻醉效果完善,术中呼吸循环稳定,具有并发症少、安全性高的优点,术后患儿苏醒快,值得临床推广。
Objective: To explore the clinical value of ketamine combined with brachial plexus block anesthesia in the operation of children’s upper limbs combined with clinical practice. Methods: 82 cases of children undergoing upper limb surgery in our hospital were selected as the research objects. The children were randomly divided into ketamine group and ketamine combined with brachial plexus block group. Different anesthesia methods were used in the operation. The anesthesia was compared between the two groups Before and after the MAP, HR, SPO2 changes, recovery time, and differences in adverse reactions to explore the effectiveness of the two anesthesia methods. Results: The recovery time of ketamine group was significantly longer than that of ketamine combined with brachial plexus block, the latter waking up quickly. Before and after anesthesia in ketamine group, MAP, HR and SPO2 changed greatly, and the difference was statistically significant. There were no significant changes in MAP, Hr and SPO2 between ketamine and brachial plexus block. Ketamine group had different degrees of adverse reactions in children, and ketamine combined with brachial plexus block was less, the incidence of various adverse reactions, the difference was statistically significant, the latter lower than the former. Conclusion: The pediatric upper limb surgery is anesthetized by the combination of ketamine and brachial plexus block. The effect of anesthesia is perfect and the respiratory cycle is stable during operation. It has the advantages of less complications and high safety. It is worthy of clinical promotion.