美托洛尔和地塞米松复合左布比卡因防治颈丛神经阻滞后心血管副反应的疗效观察  

Effect observation of the metoprolol and dexamethasone composite levobupivacaine treatment of the side effects of the cardiovascular after cervical plexus block

作　　者：武斌 胡志强 陈锦余 

机构地区：[1]广东省新兴县中医院,广东新兴527400

出　　处：《中国医药科学》2014年第14期62-64,73,共4页China Medicine And Pharmacy

基　　金：广东省云浮市医药卫生科研立项课题(2013B76)

摘　　要：目的探讨美托洛尔和地塞米松复合左布比卡因对防治颈丛神经阻滞后心血管副反应的临床疗效。方法将行甲状腺切除术的46例患者按照数字法随机分为两组,观察组23例采用美托洛尔和地塞米松复合左布比卡因麻醉,对照组23例采用左布比卡因麻醉,并比较两组的临床疗效。结果观察组的运动和感觉阻滞起效时间均短于对照组(均P<0.05),而感觉和运动维持时间则明显长于对照组(均P<0.05),观察组麻醉后10、45、90min 3个时间点的SPO2、RR与对照组比较(P均>0.05),观察组的HR和MAP在麻醉后10、45、90min与对照组比较(均P<0.05),观察组的麻醉镇痛总有效率95.65%明显高于对照组65.22%(P<0.05),观察组患者的满意度95.65%明显高于对照组的60.87%(P<0.05)。结论美托洛尔和地塞米松复合左布比卡因颈丛神经阻滞在甲状腺手术中镇痛和镇静效果更明显,术后不良反应少,安全、可靠、有效可控性好,对颈丛麻醉下甲状腺手术时的心血管反应有显著的抑制作用。Objective To discuss the clinical curative effect of the metoprolol and dexamethasone composite levobupivacaine treatment of the side effects of the cardiovascular after cervical plexus block. Methods 46 patients with thyroidectomy were randomly divided into two groups according to the figures,23 cases in the observation group were anesthetized by the metoprolol and dexamethasone composite levobupivacaine, and 23 cases in the control group were anesthetized by the levobupivacaine, and then the clinical efficacy of the two groups were compared. Results The movement and sensory block onset time of the observation group were all shorter than the control group（all P〈0.05）, but the sensory and motor maintenance time were longer than the control group（all P〈0.05）, and after anesthesia, the SPO2、RR in the three times about 10, 45, 90min were no statistically significant（all P 〉 0.05）, but HR and MAP had statistically significant（all P〈0.05）, total efficiency of narcotic analgesic with 95.65% was higher than the control group with 82.60%（P〈0.05）, and the patients’satisfaction with 95.65% was higher than the control group with 82.60%（P〈0.05）. Conclusion Metoprolol and dexamethasone composite levobupivacaine cervical plexus block in thyroid surgery analgesic and sedative effect is more obvious, less postoperative adverse reactions, safe, reliable, efficient and good controllability of the cervical plexus cardiovascular responses during thyroid surgery under anesthesia was significantly inhibited.

关 键 词：甲状腺 颈丛麻醉 美托洛尔 地塞米松 左布比卡因 

分 类 号：R614.3[医药卫生—麻醉学]