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1、臂叢神經(jīng)阻滯聯(lián)合喉罩全麻在上肢手術(shù)中的應(yīng)用周凡林(四川省成都市溫江區(qū)中醫(yī)院四川成都613000)【摘要】目的：研宄上肢手術(shù)中使用喉罩全麻聯(lián)合臂叢祌經(jīng)阻滯在臨床中帶來(lái)的效果。方法：選取我院2015年3月?2015年10月收治的上肢骨折的患者50例，隨機(jī)平均分為兩組，每組25人，觀察組患者手術(shù)時(shí)使用臂叢神經(jīng)阻滯聯(lián)合喉罩全麻，對(duì)照組患者手術(shù)時(shí)使用單純的喉罩通氣全麻。觀察組的患者先給予1.5%的利多卡因麻醉劑25毫升緩慢注入患者的肌間溝內(nèi)進(jìn)行臂叢神經(jīng)阻滯［1］。兩組的患者都使用芬太尼1微克每千克，異丙酚2毫克每千克誘導(dǎo)置入喉罩。記錄手術(shù)后患者的疼痛情況。結(jié)果：患者在T1和T
2、2時(shí)，觀察組的潮氣量明顯的比對(duì)照組患者的潮氣量高。T3時(shí)觀察組的呼吸頻率比對(duì)照組患者的呼吸頻率低。T2,T3時(shí)觀察組的MAC明顯的低于對(duì)照組的患者。觀察組的患者手術(shù)后疼痛的表現(xiàn)沒(méi)有對(duì)照組患者疼痛明顯，P<0.05。結(jié)論：在臨床上肢手術(shù)中使用臂叢祌經(jīng)阻滯聯(lián)合喉罩全麻可以降低手術(shù)后的并發(fā)癥的出現(xiàn)，減輕患者的痛苦?！娟P(guān)鍵詞】臂叢神經(jīng)阻滯；喉罩全麻；上肢手術(shù)【中圖分類號(hào)】R741【文獻(xiàn)標(biāo)識(shí)碼】A【文章編號(hào)】2095-1752(2016)11-0050-02Applicationofbrachialplexusblockcombinedwithlaryngealmaskane
3、sthesiainupperlimbsurgeryZhouFanlin.TraditionalChineseMedicineHospitalofWenjiangDistrict,ChengduCity,SichuanProvince,Chengdu613000,China【Abstract】ObjectiveTostudytheuseoflaryngealmaskanesthesiainupperextremitysurgerycombinedbrachialplexusblockintheclinicaleffects.MethodsFromMarch2015to
4、October2015were50patientswithupperlimbfractures,randomlydividedintotwogroups,eachgroupof25people,theobservationgroupofpatientswithbrachialplexusblockcombinedthelaryngealmaskanesthesiasurgery,controlgrouppatientsusesimplelaryngealmaskairwayanesthesiasurgery.Observationgrouppatientsgivef
5、irst25mlof1.5%lidocaineanesthesiaslowintramuscularinjectionpatientsforbrachialplexusblock[1].Twogroupsofpatientsareusing1microgramsperkilogramoffentanyl,propofol2mgperkilogramofinductionintothelaryngealmask.Recordaftersurgeryinpatientswithpain.ResultsInpatientswithT1andT2,thetidalvolum
6、eofobservationgroupwasobviouslybetterthancontrolgroupinpatientswithhightidalvolume.T3group'sbreathingbreathingratelowerthanthecontrolgrouppatients.T2,T3,MACofobservationgroupwasobviouslylowerthanthecontrolgroupofpatients.Observationgroupofpatientswithpainaftertheoperation,theperformanc
7、eofthecontrolgrouppatientswithpain,P<0.05.ConclusionsInclinicalupperlimbsurgerywithbrachialplexusblockcombinedthelaryngealmaskanesthesiacanreducetheoccurrenceofcomplicationsaftertheoperation,reducethepainofthepatients.【Keywords]Brachialplexusblock;Laryngealmaskanesthesia;Upperlimb
