双侧颈浅丛阻滞联合静脉全身麻醉在甲状腺手术患者中的应用  

Application of Bilateral Superficial Cervical Plexus Block Combined with Intravenous General Anesthesia in Patients with Thyroid Surgery

作　　者：王东[1] 陈彪[1] 高满海[1] 吴丽娜[1] 

机构地区：[1]内蒙古科技大学包头医学院第一附属医院,内蒙古包头014100

出　　处：《中外医学研究》2017年第12期10-12,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:双侧颈浅丛阻滞联合静脉全身麻醉在甲状腺手术患者中的应用。方法:选取行甲状腺部分切除择期手术患者40例,随机分为双侧颈浅丛阻滞联合全麻组(Ⅰ组)和全麻组(Ⅱ组),每组20例。Ⅰ组在全麻前行双侧颈浅丛阻滞,气管插管后,麻醉维持Ⅰ组用瑞芬太尼0.05~0.1μg/(kg·min)泵注并复合持续静脉输注异丙酚,Ⅱ组用瑞芬太尼0.1~0.2μg/(kg·min)泵注并复合持续静脉输注异丙酚,观察两组手术切皮时(t_1)、分离甲状腺(t_2)、部分切除甲状腺(t_3)和拔管时(t_4)的平均动脉压(MAP)和心率(HR)的变化;记录苏醒后0、6、12、24 h的视觉模拟评分(VAS);计算瑞芬太尼用药量。结果:Ⅰ组手术切皮时、分离甲状腺和部分切除甲状腺时的MAP、HR明显低于Ⅱ组(P<0.05);拔管时的MAP、HR比较,差异无统计学意义(P>0.05);Ⅰ组手术中的瑞芬太尼用量明显少于Ⅱ组(P<0.01);术后疼痛VAS评分在苏醒后0、6、12 h时Ⅰ组明显优于Ⅱ组(P<0.05),术后24 h相比较,差异无统计学意义(P>0.05)。结论:双侧颈浅丛阻滞复合静脉全身麻醉在甲状腺手术时维持血流动力学稳定方面明显优于静脉全身麻醉,并可减轻术后疼痛,减少全麻药的用量,有良好的临床效果。Objective： To investigate bilateral superficial cervical plexus block combined with intravenous general anesthesia in the optional application of patients with thyroid surgery.Method： 40 patients undergoing partial thyroidectomy elective surgery were selected and randomly divided into two groups： general anesthesia combined with bilateral superficial cervical plexus block group（group I） and general anesthesia group（group II）, 20 cases in each group.Group I was given general anesthesia on the basis of bilateral superficial cervical plexus block.After tracheal intubation, anesthesia was maintained by Remifentanil 0.05-0.1 μg/（kg · min） in group I and Remifentanil 0.1-0.2 μg/（kg · min） in group II with an intravenous infusion of Propofol.Mean arterial pressure（MAP） and heart rate（HR） changes of the two groups were observed during skin incision（t1）, isolated thyroid（t2）, partial resection of thyroid（t3） and extubation（t4）.The visual analogue scale（VAS） was recorded 0, 6, 12 and 24 h after revival, the dose of remifentanil was calculated.Result： The MAP, HR of group I during skin incision, separation of thyroid and partial resection of thyroid were significantly lower than those of group II（P〈0.05）; Extubation MAP, HR of the two groups had no significant difference（P〉0.05）.The dosage of remifentanil of the group I was significantly less than that of group II（P〈0.01）.The postoperative VAS scores of group I were significantly better than those of group II 0, 6 and 12 h after revival（P〈0.05）, 24 h after revival the two groups had no significant difference（P〉0.05）. Conclusion： Bilateral superficial cervical plexus block combined with intravenous general anesthesia in thyroid surgery and maintain hemodynamic stability is better than total intravenous anesthesia, and can reduce postoperative pain, reduce the amount of anesthetics, has a good clinical effect.

关 键 词：甲状腺手术 双侧颈浅丛阻滞 静脉全身麻醉 

分 类 号：R614[医药卫生—麻醉学]