Application of ultrasonic guidance in brachial plexus block anesthesia for pediatric upper extremity operation
Objective Compared with conventional tracheal intubation general anesthesia, non -intubating shallow general anesthesia combined with axillary brachial plexus block anesthesia can avoid mechanical injury during tracheal intubation/extubation, as well as medication risk caused by large doses of sedative and analgesic drugs and prolongation of postoperative recovery time. However, due to the special anatomical structure of brachial plexus in children,it is difficult to locate brachial plexus. Therefore,ultrasound guidance technology is clinically attempted to solve the problem of inaccurate puncture positioning during surgery. This paper aims to explore the application effect of ultrasound guidance in pediatric upper limb surgery anesthesia under non-intubating shallow general anesthesia combined with axillary brachial plexus block. Methods Pediatric patients who underwent upper limb surgery and used axillary brachial plexus block anesthesia in Pingdingshan Hospital of Henan Province from 2018 to 2023 were selected and divided into study group and control group according to whether or not they underwent brachial plexus block with ultrasound guidance. By comparing the differences of parameters,such as brachial plexus block time,anesthetic drug dose, anesthetic drug onset time, postoperative pain evaluation FLACC score at each time point after recovery, and postoperative adverse reactions, the application effect of ultrasound guidance in axillary brachial plexus block anesthesia for upper limb surgery in children was evaluated. Results A total of 190 patients were enrolled,55 cases were in the study group and 135 in the control group. There was no statistical significance in clinical data such as gender, age, height, weight and disease type between the two groups ( P>0. 05 ) . The dosage of ropivacaine in the study group was significantly lower than that in the control group ( P<0. 01) ,but the onset time of brachial plexus block was significantly earlier than that in the control group ( P<0. 01) . The amount of anesthetic drugs propofol and fentanyl in the study group were lower than those in the control group ( P<0. 05) . Forthermore in the control group,8 patients had branch block remedy,8 patients used ibuprofen to relieve pain after surgery,2 patients had nausea and vomiting,and 1 child had restlessness during the recovery period,which were significantly higher than that in the study group ( P<0. 01 ) . Conclusions Ultrasound guidance plays an important role in axillary brachial plexus block anesthesia in upper extremity surgery in children.
ultrasonic equipmentultrasonic guidancebrachial plexus blocknon-intubation general anesthesiaupper extremity surgery in childrenapplication effect
万方数据
维普
