Application of Brachial Plexus Block Guided by B Ultrasound in Operation of Ulna and Radius Fracture in Children / 医学研究杂志

ABSTRACT

Objective To investigate the effect of B-guided brachial plexus block anesthesia on postoperative cognitive function and serum neurotrophic factor (NGF) and transforming growth factor-β (TGF-β) levels in children with ulnar and radius fractures.Methods From February 2014 to January 2017,we selected 78 children with ulnar radius fractures in our hospital randomly and divided them into observation group and control group,each group 39 cases.The control group was given brachial plexus block anesthesia under the position of nerve stimulation,and the observation group was subjected to B-guided brachial plexus block anesthesia.Anesthesia-related indicators,anesthetic effects and complications were observed and analyzed between the two groups,and hemodynamics parameters of brachial plexus block after 0.5h,cognitive function and serum NGF and TGF-β levels before and after operation were compared.Results Compared with the control group,anesthesia onset,recovery room stay time in the observation group were shorter and the duration of analgesia was longer (P ＜ 0.05).The excellent and good rate of anesthesia in the observation group 97.44％ (38/39) was higher than that in the control group (76.92％,30/39).The incidence of complications in the observation group 5.12％ (2/39) was much lower than that of the control group (23.08％,9/39,P ＜ 0.05).There was no significant difference in systolic peak velocity between the two groups (P ＞ 0.05).Compared with the control group,the end of the diastolic velocity and blood flow of brachial plexus block after 0.5h were higher,resistance and pulsatility index were lower (P ＜ 0.05).There was no significant difference in preoperative cognitive function,serum NGF and TGF-β levels between the two groups before operation (P ＞ 0.05).After operation,compared with the control group,the cognitive function,serum NGF and TGF-β levels were higher in the observation group (P ＜ 0.05).Conclusion Anesthesia effect of B-guided brachial plexus block anesthesia is significant in children with ulnar radius fractures.The incidence of complications is low,which can significantly improve the ulnar arterial hemodynamics,significantly increased serum NGF,TGF-β levels,contribute to postoperative fracture healing,and will not affect the cognitive function of children after surgery.