复方利多卡因乳膏用于减轻臂丛神经阻滞术穿刺痛的效果观察.docVIP

精品论文 参考文献 复方利多卡因乳膏用于减轻臂丛神经阻滞术穿刺痛的效果观察 辽宁省丹东市解放军第230医院麻醉科 118000 【摘 要】目的：探讨复方利多卡因乳膏在臂丛神经阻滞术中降低患者疼痛的效果观察。方法：将接受臂丛神经阻滞术病人60例随机分为实验组和对照组各30例。实验组术前15-30min用5%复方利多卡因乳膏1.5g/10cm2在穿刺部位进行涂抹并用保鲜膜贴敷封包。对照组采用常规方法不给于任何处理。对两组穿刺疼痛程度和穿刺前后血压、心率的变化情况进行观察比较。结果：两组臂丛神经阻滞穿刺疼痛程度及穿刺后血压、心率比较有显著差异（plt;0.05）。结论：实施臂丛神经阻滞前涂抹复方利多卡因乳膏明显减轻患者穿刺痛，穿刺前后血压、心率无明显变化。 【关键词】复方利多卡因乳膏；臂丛神经阻滞；效果观察 Abstract：objective：to investigate the compound lidocaine cream in patients with brachial plexus block in reducing pain effect observation. Methods：will accept the brachial plexus block 60 patients were randomly divided into experimental group and control group 30 cases each. Experimental group before 15 to 30 min with 5% compound lidocaine cream 1.5 g / 10 cm2 in puncture were applied with plastic wrap and the packet. The control group using conventional methods do not give to any treatment. On two groups of piercing pain degree and the change of blood pressure and heart rate were observed before and after the biopsy. Results：two groups of brachial plexus nerve block after piercing pain degree and the puncture blood pressure，heart rate was significant difference（p lt; 0.05）. Conclusion：the implementation of the brachial plexus block before daub compound lidocaine cream significantly reduce the piercing pain patients，blood pressure，heart rate has no obvious change before and after puncture. Key words：compound lidocaine cream；Brachial plexus block；Results observation 随着舒适化麻醉理念的提出，对临床麻醉工作提出了新的挑战。实行臂丛神经阻滞术的患者，常因为术前紧张焦虑、穿刺针头粗等原因在实施神经阻滞穿刺时恐惧，疼痛不配合【1】，给患者生理和心理上带来极大痛苦，从而降低了治疗的依从性和神经阻滞穿刺成功率。复方利多卡因乳膏对于粘膜有创操作的麻醉镇痛作用已被证实，在国内外已被广泛应用【2】。现将复方利多卡因乳膏减低臂丛神经阻滞术穿刺痛的有效性，报道如下。 1 资料与方法 1.1 临床资料 选择2014年3月至2015年3月实施臂丛神经阻滞术的病人60例，男性38例，女性22例，年龄16~45岁；全部采用肌间沟臂丛神经阻滞术。其中肱骨骨折21例，前臂双骨折13例，前臂离断伤18例，8例手外伤。将60例患者随机分为实验组和对照组。所有患者ASAⅠ~П级，既往无心肺等器质性疾病，各年龄组及手术无明显差异。 1.2 方法 实验组术前30~60min均在病房于神经阻滞部位涂抹5%复方利多卡因乳膏1.5-2.0g/10cm2并用保鲜膜贴敷封包。入室后常规监测BP、ECG、Spo2，开放外周静脉，吸氧3L/min。擦去复方利多卡因乳膏，消毒皮肤用神经阻滞针进行常规肌间沟臂丛神经阻滞麻醉；对照组进行常规麻醉，提前不给于任何处理。