摘要
目的 观察利用周围神经刺激器辅助定位,罗比卡因臂丛神经阻滞复合氯胺酮静脉麻醉在小儿上肢手术中应用,对呼吸循环功能以及术后恢复情况的影响。方法 5 0例行上肢手术患儿随机分为两组:臂丛神经阻滞复合氯胺酮静脉麻醉组(A组,n =2 5 ) ,氯胺酮基础麻醉后,应用神经刺激器辅助定位臂丛阻滞成功后注入0 .2 5 %罗比卡因0 .5ml kg;单纯氯胺酮静脉麻醉组(B组,n =2 5 ) ,术中氯胺酮1- 2mg (kg·h)间断静注。结果 术中A组循环、呼吸功能较B组稳定(P <0 .0 5 ) ;肢体不良自主运动,喉痉挛等不良反应较B组少(P <0 .0 5 ) ;A组氯胺酮用量明显少于B组(P <0 .0 1) ;术后A组苏醒较快且平稳,恢复期精神症状少,与B组比有显著差异(P <0 .0 5 )。结论 臂丛神经阻滞复合氯胺酮静脉麻醉应用于小儿上肢手术,可减少氯胺酮用量从而减少其不良反应,使患儿在麻醉手术期间呼吸循环更平稳,家长及医护人员满意度明显提高。
Objective Observing the effect of breath and recovery of the operation when using the ropivacaine plexus brachialis nerves block which is position by ground Nerve Stimulator combined with ketamine intravenous anesthesia.Methods Fifty children undergoing arm operation were randomly divided into two groups:Plexus brachialis nerves block combined with ketamine intravenous anesthesia (group A, n=25), after ketamine based aneathasia, ropivacaine 0.5ml/kg was injected to plexus brachialis which is site by Nerve Stimulator; ketamine intravenous anesthesia (group B, n=25), ketamine 1-2mg/(kg·h) was injected intravenous disconnected.Results The breath and circulation in group A is more steadily than group B during the operation (P<0.05). The incidence of body movement and larynx spasm is higher in group B (P<0.05).The quantity of ketamine is less in group A than group B. The recovery is faster and more steadily in group A, which is obviously difference of group B(P<0.05).Conclusions Plexus brachialis nerves block combined with ketamine intravenous anesthesia used in the operation of children's arm can decrease the quantity of ketamine to reduce the uncomfortable response.In this way, the children's breath and circulation is more steadily during the anesthesia and operation. The parents and doctors' satisfactory are highly increased.
出处
《宁夏医学杂志》
CAS
2005年第5期322-323,共2页
Ningxia Medical Journal
关键词
臂丛神经阻滞
氟胺酮
静脉麻醉
手术
Plexus brachialis nerves block
Ropivacaine
Ketamine
Intravenous anesthesia
Pperation
