颈神经丛阻滞甲状腺手术辅以右美托咪定的临床疗效  

Clinical effect of cervical plexus block thyroid operation with dexmedetomidine

作　　者：张显平[1] 王开祥[1] 

机构地区：[1]山东省滕州市中心人民医院麻醉科,277500

出　　处：《中国实用医刊》2012年第17期27-29,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察颈神经丛阻滞甲状腺手术辅以右美托咪定的应用效果。方法择期甲状腺手术患者60例，ASAⅠ或Ⅱ级，随机分为三组：右美托咪定组（D组）、咪达唑仑组（M组）和对照组（C组）。三组都以改良一针法和相同局部麻醉药施颈神经丛阻滞。D组在阻滞前泵注右关托咪定负荷量1μg/kg，恒速10min，持续量0．4～0．6μg／（kg·h）。M组在阻滞后静脉注射咪达唑仑0．04mg／kg。记录基础值（T0）、颈神经丛阻滞后10min（T1）、20min（T2）、30min（L）及手术结束时（T4）的收缩压（SBP）、舒张压（DBP）、心率（HR）、脉搏血氧饱和度（SpO2）和SBP与HR的乘积（RPP）。结果C组T1～T4各指标均明显高于T0时（P〈0．05）；M组和D组T1～T4各指标均明显低于C组（P〈0．05）；D组较M组T1～T4各指标虽稍低但无统计学意义（P〉0．05）。结论甲状腺手术辅以右美托咪定镇静、镇痛效果可靠，能有效抑制颈神经丛阻滞导致的心血管不良反应。Objective To observe the application effect of cervical plexus block thyroid opera- tion with dexmedetomidine. Methods Selective thyroid operation in 60 cases, ASA Ⅰ or Ⅱ, were ran- domly divided into three groups： dexmedetomidine group （group D）, midazolam group （group M） and control group （group C）. The three groups were given improved method and the same application of cer- vical plexus block with local anesthetics. Dexmedetomidine of 1 μg/kg was infused before block in group D for 10 rain, with constant speed, constant amount of 0.4 -0. 6 μg/（kg·b）. In group M, intravenous injection of midazolam 0.04 mg/kg were given. The base value （ T0 ） , cervical plexus block after 10 min （T1）, 20 min （T2）, 30 min （T3） and SBP, DBP, HR, SpO2 and SBP and HR （RPP） at the end of openation （T4 ） were recorded. Results In group C, each indexes in T1 -T4 were significantly higher than those in TO （P 〈 0.05 ） ; each indexes in group M and D T1 -T4 were significantly lower than those in group C （ P 〈 0. 05 ） ; each indixes in group D than in group M at T1 - T4, but there was no significant difference （P 〉 0. 05 ）. Conclusions Thyroid operation with dexmedetomidine sedation, analgesia effect is reliable, and can effectively inhibit the cardiovascular side effects in cervical plexus block.

关 键 词：右美托咪定 颈神经丛阻滞 血流动力学 

分 类 号：R614[医药卫生—麻醉学]