颈丛吗啡联合静脉芬太尼在腔镜甲状腺切除术后镇痛的效果观察  

Clinical observation of PCIA with cervical nerves anesthesia block combined morphine and intravenous fentanyl for pain treatment after thyroscopic thyroidectomy

作　　者：吴国远[1] 覃立圣[1] 赵志钢[1] 曹嵩[1] 

机构地区：[1]广西中医学院第三附属医院,广西柳州545001

出　　处：《华夏医学》2007年第4期684-685,共2页Acta Medicinae Sinica

基　　金：广西卫生厅[2005]自筹资金项目;合同号z2005193

摘　　要：目的:探讨颈丛吗啡联合静脉芬太尼应用于腔镜甲状腺切除术后的镇痛效果。方法:将28例择期行甲状腺手术患者分为两组,其中实验组14例,对照组14例。实验组于静脉开放后,以0.75%布比卡因5ml+2%利多卡因5ml+吗啡2mg行双侧颈浅丛穿刺注射,每侧5ml,术毕给予芬太尼1.0mg+力月西10mg加生理盐水至100ml行PCIA。而对照组则不行颈浅丛注射,术毕给予芬太尼1.0mg+力月西10mg加生理盐水至100ml行PCIA。结果:实验组中有1例镇痛效果差,术后需用哌替啶肌肉注射,其余13例镇痛效果良好;而对照组中有5例镇痛效果差,需用哌替啶肌肉注射。单位时间内对照组PCIA芬太尼用量比实验组多,不良反应如恶心、呕吐的发生率与实验组相比亦相同,P>0.05。结论:颈丛吗啡联合静脉芬太尼具有镇痛效果好,操作方法简便,具有一定的临床应用价值。Objective ：To discuss the pain treatment of PCIA with cervical nerves anesthesia block combined morphine and intravenous fentanyl after thyroseope thyroideettomy, Methods： 28 patients were randomly divided into two groups ,each group 14 cases ,study group were received double cervical nerves anesthesia block with 0.75% bupivaeaine 5ml, 2 % lidoeaine 5ml ,morphine 2rag and PCIA with fentanyl 1.0mg,midazolam 10 mg after operation ; control group was received only PCIA with fentanyl 1.0mg,midazolam 10mg after operation. Results：13 cases of study group had good pain treatment effects except only 1 case needs dolantin intramuscle injection after operation and that of 7 cases in control group need dolantin intramuscle injection. Fentanyl requirement was significantly reduced and the incidences of nausea and vomiting were singnificantly lower in single time in study group as compared with control group （P〉0.05）. Conclusion：The method is easy to perform with good pain treatment ,effects and low adverse effects. It has certain clinical application value.

关 键 词：颈丛神经 吗啡 PCIA 甲状腺切除术 

分 类 号：R614.27[医药卫生—麻醉学] R653[医药卫生—外科学]