论文部分内容阅读
目的:探讨儿童股骨干骨折手术中应用经超声引导下股神经-股外侧皮神经阻滞联合全身麻醉的效果。方法:抽取2018年1月至2020年1月于洛阳正骨医院接受股骨干骨折手术治疗的患儿62例，采用随机数字表法分为观察组和对照组，每组31例。对照组接受全身麻醉，观察组接受超声引导下股神经-股外侧皮神经阻滞联合全身麻醉，分别于入室时(T0)、切皮时(T1)、骨折端复位时(T2)及手术结束时(T3)记录两组患儿的血流动力学变化情况。记录两组手术相关指标及苏醒期间不良事件发生情况，并对上述指标进行比较分析。结果:两组心率、平均动脉压(MAP)水平在T1时点均较T0时点升高，但在T2时点较T1时点回降，T3时点较T2时点回升，且观察组T1、T2、T3时点心率、MAP水平均低于对照组(n P均<0.05)。观察组术中芬太尼用量少于对照组[(161.35±48.98)μg比(256.79±58.46)μg]，n P<0.05；拔管时间[(7.13±2.31)min]、留置恢复室总时间[(42.31±3.52)min]短于对照组[(22.64±4.32)min、(73.01±10.34)min]，n P<0.05。观察组苏醒期间躁动、恶心呕吐发生率[0.00%(0/31)、3.23%(1/31)]低于对照组[19.35%(6/31)、25.81%(8/31)]，n P<0.05。n 结论:儿童股骨干骨折术中应用经超声引导下股神经-股外侧皮神经阻滞联合全身麻醉效果显著，且安全性好。“,”Objective:To investigate the effect of ultrasound-guided femoral-lateral femoral cutaneous nerve block combined with general anesthesia in the treatment of femoral shaft fracture in children.Methods:A total of 62 children who underwent surgical treatment of femoral shaft fractures in Luoyang Orthopedic-Traumatological Hospital of Henan Province from January 2018 to January 2020 were selected. According to the random number table method, they were divided into observation group and control group, with 31 cases in each group. The control group received general anesthesia, and the observation group received ultrasound-guided femoral-lateral femoral cutaneous nerve block combined with general anesthesia. The changes of hemodynamics of the two groups were recorded at the time of entry (T0), at the time of skin incision (T1), at the time of fracture reduction (T2), and at the end of the operation (T3). The operation-related indicators, occurrence of adverse events during the recovery period of the two groups were recorded. And the above indexes were analyzed and compared between the two groups.Results:The levels of heart rate (HR), mean arterial pressure (MAP) in the two groups at T1 were higher than those at T0, but they decreased at T2, compared with those at T1. While HR and MAP increased at T3 in the two groups, compared with those at T2 (n P<0.05). The levels of HR, MAP at T1, T2 and T3 in the observation group were lower than those in the control group (n P<0.05). The intraoperative dosage of fentanyl of the observation group was (161.35±48.98)μg, less than the (256.79±58.46)μg of the control group (n P<0.05). And the extubation time and total time of indwelling recovery room were (7.13±2.31)min and (42.31±3.52) min respectively, in the observation group, shorter than the (22.64±4.32)min and (73.01±10.34)min of the control group (n P<0.05). The incidences of restlessness, nausea and vomiting during the recovery period of the observation group were 0.00%(0/31) and 3.23%(1/31), respectively, lower than the 19.35%(6/31) and 25.81%(8/31) of the control group (n P<0.05).n Conclusions:Ultrasound guided femoral-lateral femoral cutaneous nerve block combined with general anesthesia is effective in the treatment of femoral shaft fractures in children, with good safety.