肌间沟法臂丛阻滞在学龄前儿童肱骨髁上骨折手术的效果.pdfVIP

实用医技杂志 2008年7月蒋15卷第2O期 JPMT，July．2008，Vo1．15，No．20 · 2593· 肌间沟法臂丛阻滞在学龄前儿童肱骨髁 上骨折手术的效果 张习良，王杰华，区锦燕 (佛山市中医院，广东佛山528000) 【摘 要]目旬：观察肌间沟法臂丛阻滞在学龄前小儿肱骨髁上骨折手术中的效果。方法：3岁～6岁肱骨髁上骨 折择期手术病例国例：随机分为三组(各20例)。I组(静脉全麻组)、II组(低剂量臂丛组)、III组(高剂量臂丛组)。I 组用氯胺酮，异丙玢静脉全麻。II组(低剂量臂丛组)：臂丛用1％ffq多卡因(含肾上腺素1／20万)0、5 ml／kg。Ⅲ组(高剂 量臂丛组)：臂丛用药量0．8ml／kg。观察各组切皮前后、术中心率、血压，氯胺酮用量，术后苏醒时间。II组、IⅡ组不需追 加氯胺酮的例数。结果：Ⅱ组、IU组比I组苏醒快，心率、血压平稳。Ⅲ组比II组追加氯胺酮例数少。结论：肌间沟入路 臂丛神经阻滞可安全、有效应用于小儿肱骨髁上骨折手术。 【关键词】臂丛神经阻滞；肌间沟；学龄前儿童；肱骨髁上骨折 [中图分类号]R683A1[文献标识码]A[文章编号]1671—5098(2008)20-2593-02 Effect ofIntermuseular Point Braehial Plexus Block in Ol~rafion ofHumeral Supracondyhr Fracmm in Preschool Child ZHANG Xi．1iang,Ⅵ ANG Jie-hua,0U Jin—yah ~Foshan Hospital of Traditional Chinese胁 c 船，Foshan，Guangdong 528000’C n Abstmct：Objmtive Observe the effect of intermuscular point bmc~al plexus nerve block in operation of humeral supracondylar frac~-e in preschoolchild．Methods 60 cases from3—6 year patients of humeral supracondylar fracture are av— erage random to three groups：I group(general intravenous anesthesia)：used by k~amine and diprivan．II group(1ow dose brachial plexus bloc[)：intermuscular point brachial plexus block by lidocaine 0．5 ml／kg，IIIgroup(hi dose brachial plexus block)．IIIgroup：the dose oflidocaine is 0．8 ml／kg．Observe HR、BP before the operation,just in cutting the skin、during the operation，the total dose ofketamine and the time ofrecovery in each group，and the sum ofcases that keatamine not used ad— ditional in II group ardIIIgroup．Results The time ofrecovery is longer and the total dose ofketamine is larger in I group．HR and BP stable in II gmup and III group．Gonsusion Intermuscular point brac