静脉全麻复合双侧颈丛浅神经阻滞对老年甲状腺手术患者术后恶心呕吐的影响  

Effect of intravenous anesthesia combined with bilateral superficial cervical plexus block on the incidence of postoperative nausea and vomiting in elderly patients undergoing thyroid surgery

作　　者：朱炜[1] 杨许丽[1] 崔士和[1] 周路阳[1] ZHU Wei YANG Xu-li CUI Shi-he ZHOU Lu-yang.(Department of Anesthesiology, Drum Tower Hospital, Medical College of Nanjing University, Nanjing 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,江苏省南京市210008

出　　处：《实用老年医学》2016年第12期997-999,共3页Practical Geriatrics

基　　金：南京市医学科技发展重点项目(ZKX14025);南京市医学科技发展项目(YKK13069)

摘　　要：目的评估和比较双侧颈丛浅神经阻滞联合静脉全麻和单纯静脉全麻对老年甲状腺手术患者术后恶心呕吐（postoperative nausea and vomiting,PONV）发生率的影响。方法选择全麻下择期行甲状腺手术的老年患者60例,随机分为A、B 2组,每组30例。A组患者实施单纯静脉麻醉,常规快速诱导。B组在麻醉诱导平稳10 min后实施双侧颈丛浅神经阻滞。观察并记录2组术后12 h内、12~24 h、24~48 h患者PONV的发生情况以及相同时点的疼痛评分（VAS评分）和意识评分（Ramsay评分）。结果 A组术后12 h内、12~24 h PONV发生率明显高于B组（P〈0.05）,术后24~48 h 2组PONV发生率差异无统计学意义（P〉0.05）。A组术后各时点VAS评分均显著高于B组（P〈0.05）,2组间Ramsay评分差异无统计学意义（P〉0.05）。结论静脉全麻复合双侧颈丛浅神经阻滞对降低老年甲状腺手术患者术后PONV的发生具有较好的作用。Objective To evaluate and compare the of incidence rate of postoperative nausea and vomiting（ PONV）between patients receiving intravenous anesthesia completely or combined with bilateral superficial cervical plexus block in thyroid surgery. Methods Sixty elderly patients scheduled to thyroid surgery under general anesthesia were randomly divided into two groups,with 30 cases in each group. Patients in group A only underwent intravenous anesthesia,with conventional rapid induction. Patients in group B received bilateral superficial cervical plexus nerve block 10 min after the same induction with group A. At the time period of 0-12 h,12-24 h and 24-48 h postoperation,the incidence rate of PONV was recorded,the pain score（ VAS score） and consciousness score（ Ramsay score） were accessed at the time points of 12 h,24 h and 48 h. Results At the time period of 0-12 h,12-24 h after operation,the incidence rate of PONV in group A was significantly higher than that in group B,but there was no significant difference at the time of 24-48 h postoperation between two groups. The VAS score at each time point in group A was significantly higher than that in group B. There was no significant difference in Ramsay score between two groups. Conclusions Intravenous general anesthesia combined with bilateral superficial cervical plexus block has a good effect on reducing the incidence of PONV in elderly patients with thyroid surgery,and can significantly reduce the use of other antiemetics.

关 键 词：甲状腺 颈浅丛阻滞 静脉全麻 恶心呕吐 老年人 

分 类 号：R614.2[医药卫生—麻醉学]