B超引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者的麻醉效果分析

摘要 目的：研究B超引导下臂丛神经阻滞麻醉对老年桡骨远端粉碎性骨折患者的麻醉效果。方法：选择2018年12月～2020年6月我院的80例老年桡骨远端粉碎性骨折患者，采用随机数字表法，将患者均分为两组。两组均实施臂丛神经阻滞麻醉，其中对照组使用传统的解剖定位法，观察组使用B超引导法。比较两组的麻醉效果、麻醉用药剂量、阻滞起效时间、麻醉完成时间、镇痛维持时间；不同时间的平均动脉压、心率；且记录两组的脊髓麻痹、气胸、呼吸困难、局麻药物中毒发生率。结果：观察组老年桡骨远端粉碎性骨折病人的麻醉效果优良率（95.00 %）明显高于对照组（77.50 %，P<0.05)；观察组的麻醉用药剂量、阻滞起效时间、麻醉完成时间均显著低于对照组，镇痛维持时间长于对照组(P<0.05)；两组T2和T3时间点的平均动脉压和心率明显高于T1(P<0.05)，且观察组的平均动脉压和心率明显更低(P<0.05)；观察组的脊髓麻痹、气胸、呼吸困难、局麻药物中毒发生率明显更低(P<0.05)。结论：B超引导臂丛神经阻滞麻醉能提高老年桡骨远端粉碎性骨折患者的麻醉效果。

Analysis of the Anesthetic Effect of Brachial Plexus Block Anesthesia Guided by B-ultrasound in Elderly Patients with Comminuted Distal Radius Fractures

ABSTRACT Objective: Objective to study the anesthesia effect of brachial plexus block under the guidance of B-ultrasound in elderly patients with comminuted distal radius fracture. Methods: 80 cases of elderly patients with comminuted distal radius fractures in our hospital from December 2018 to June 2020, undergoing intracranial tumor resection ,were divided into two groups. Two groups were given brachial plexus block anesthesia, the control group used the traditional anatomical positioning method, and the observation group used B-ultrasound guidance method. The anesthetic effect, anesthetic dosage, block onset time, anesthesia completion time, analgesia maintenance time, mean arterial pressure and heart rate at different times were compared between the two groups, and the incidence of spinal cord paralysis, pneumothorax, dyspnea and local anesthetic poisoning were recorded. Results: The excellent and good rate of anesthesia effect in the observation group (95.00 %) was significantly higher than that in the control group (77.50 %, P<0.05). The anesthetic dosage, block onset time and anesthesia completion time of the observation group were significantly lower than those of the control group (P<0.05), and the analgesic maintenance time of the observation group was significantly longer than that of the control group (P<0.05). The mean arterial pressure and heart rate of the two groups at T2 and T3 were significantly higher than those at T1(P<0.05), and the mean arterial pressure and heart rate of the observation group were significantly lower(P<0.05). The incidence of spinal cord paralysis, pneumothorax, dyspnea and local anesthetic drug poisoning in the observation group was significantly lower(P<0.05). Conclusion: Ultrasound guided brachial plexus block anesthesia can improve the anesthetic effect of elderly patients with comminuted distal radius fractures.