中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
34期
24-25,27
,共3页
王琼华%方晏红%杨帆%李卫东
王瓊華%方晏紅%楊帆%李衛東
왕경화%방안홍%양범%리위동
全麻%臂丛阻滞%上肢手术%镇痛
全痳%臂叢阻滯%上肢手術%鎮痛
전마%비총조체%상지수술%진통
General anesthesia%Brachial plexus block%Upper limb surgery%Analgesia
目的：比较全麻复合臂丛阻滞与单纯全麻在上肢手术中的麻醉效果及对术中麻醉和术后恢复的影响。方法：将62例上肢手术患者随机分为全麻组(GA组)和全麻复合臂丛神经阻滞组(GB组)，GA组行PCIA术后镇痛，GB组安置持续神经丛自控镇痛泵，观察两种麻醉方法下丙泊酚及舒芬太尼总用量、术后苏醒时间、拔管时间、恶心、呕吐不良反应发生情况，以及术后镇痛效果评价。结果：GB组丙泊酚及舒芬太尼总用量少于GA组。术后苏醒时间、拔管时间均短于 GA 组，术后 VAS 评分明显低于 GA 组，术后镇痛总用药量减少，PCA 按压次数减少，术后不良反应减少。差异均有统计学意义(P＜0.05)。结论：全麻复合臂丛阻滞以及单独全麻均可以应用于上肢手术的患者，但全麻复合臂丛阻滞在用药量以及术后镇痛效果和不良反应方面更具有优势。
目的：比較全痳複閤臂叢阻滯與單純全痳在上肢手術中的痳醉效果及對術中痳醉和術後恢複的影響。方法：將62例上肢手術患者隨機分為全痳組(GA組)和全痳複閤臂叢神經阻滯組(GB組)，GA組行PCIA術後鎮痛，GB組安置持續神經叢自控鎮痛泵，觀察兩種痳醉方法下丙泊酚及舒芬太尼總用量、術後囌醒時間、拔管時間、噁心、嘔吐不良反應髮生情況，以及術後鎮痛效果評價。結果：GB組丙泊酚及舒芬太尼總用量少于GA組。術後囌醒時間、拔管時間均短于 GA 組，術後 VAS 評分明顯低于 GA 組，術後鎮痛總用藥量減少，PCA 按壓次數減少，術後不良反應減少。差異均有統計學意義(P＜0.05)。結論：全痳複閤臂叢阻滯以及單獨全痳均可以應用于上肢手術的患者，但全痳複閤臂叢阻滯在用藥量以及術後鎮痛效果和不良反應方麵更具有優勢。
목적：비교전마복합비총조체여단순전마재상지수술중적마취효과급대술중마취화술후회복적영향。방법：장62례상지수술환자수궤분위전마조(GA조)화전마복합비총신경조체조(GB조)，GA조행PCIA술후진통，GB조안치지속신경총자공진통빙，관찰량충마취방법하병박분급서분태니총용량、술후소성시간、발관시간、악심、구토불량반응발생정황，이급술후진통효과평개。결과：GB조병박분급서분태니총용량소우GA조。술후소성시간、발관시간균단우 GA 조，술후 VAS 평분명현저우 GA 조，술후진통총용약량감소，PCA 안압차수감소，술후불량반응감소。차이균유통계학의의(P＜0.05)。결론：전마복합비총조체이급단독전마균가이응용우상지수술적환자，단전마복합비총조체재용약량이급술후진통효과화불량반응방면경구유우세。
Objective:To compare the anesthetic effects and the impact on intraoperative anesthesia and postoperative recovery of general anesthesia combined with brachial plexus block and general anesthesia in upper limb surgery.Methods:62 patients with upper limb surgery were divided into the general anesthesia group(GA group) and the general anesthesia combined with brachial plexus block group(GB group) randomly.GA group underwent postoperative controlled infusion analgesia(PCIA).GB group accepted continued plexus analgesia pump, observing the total dosage of propofol and sufentanil respectively,postoperative recovery time,extubation time,adverse events including nausea and vomiting,and the postoperative analgesia evaluation.Results:The total amount of propofol and sufentanil of GB group was less than that of the GA group.The postoperative recovery time, extubation time were shorter than those of GA group.VAS scores were significantly lower than those of GA group.The total drug dosage for postoperative analgesia of GB group decreased and the frequency of PCA pressed decreased,which had less postoperative adverse reactions.The differences were statistically significant (P<0.05).Conclusion:General anesthesia combined with brachial plexus block and general anesthesia can be applied to patients with upper limb surgery,but general anesthesia combined with brachial plexus block has more advantages on anaesthetic dosage,postoperative analgesia and adverse reactions.
