右美托咪定辅助全麻复合颈丛阻滞在甲状腺手术中的应用效果观察  

Effect of the application of dexmedetomidine-assisted cervical plexus block combined with general anesthesia in thyroid surgery

作　　者：杨伟才[1] 吴丹丹 莫海龙[1] YANG Wei-cai;WU Dan-dan;MO Hai-long(Department of Anesthesiology, the Peopled Hospital of Lianjiang, Lianjiang 524400, China)

机构地区：[1]广东省廉江市人民医院麻醉科,广东廉江524400

出　　处：《广东医科大学学报》2019年第1期48-51,共4页Journal of Guangdong Medical University

摘　　要：目的观察右美托咪定(Dex)辅助全麻复合颈丛阻滞在甲状腺手术中的应用效果。方法将100例行甲状腺手术患者随机分为观察组和对照组,每组50例。对照组采用全麻复合颈丛阻滞,观察组在对照组的基础上给予持续泵注Dex 0.7μg/(kg·h)。检测两组患者入手术室前(T0)、切皮前(T1)、切皮时(T2)、术中分离颈前筋膜时(T3)、处理腺体时(T4)和手术结束时(T5)的心率(HR)、血氧饱和度(SpO_2)、平均动脉压(MAP)、血糖和血清皮质醇浓度。统计两组不良反应的发生情况。结果观察组在T1、T2、 T3和T4时的HR和MAP水平,以及在T1、T2、T3、T4和T5时的血糖和血清皮质醇浓度均明显低于对照组(P<0.01或0.05),不良反应总发生率也明显低于对照组(P<0.05)。结论 Dex辅助全麻复合颈丛阻滞可使甲状腺手术患者的血流动学更加平稳,同时可降低应激反应程度和不良反应的发生率。Objective To investigate the effect of the application of dexmedetomidine dexmedetomidine(Dex)-assisted cervical plexus block combined with general anesthesia in thyroid surgery. Methods A total of 100 patients who underwent thyroid surgery were randomly divided into Observation Group and Control Group, 50 cases in each group. The Control Group was treated with cervical plexus block combined with general anesthesia while the Observation Group was given continuous pump infusion of 0.7 μg/(kg·h) Dex on the basis of the treatment for the Control Group. The heart rate(HR), blood oxygen saturation(SpO2), mean arterial pressure(MAP), blood glucose and serum cortisol concentration of the two groups were measured before patients’ entering operation room(T0), before skin incision(T1), during skin incision(T2), during anterior cervical fascia dissection(T3), during dealing with glands(T4) and at the end of operation(T5). The incidence of adverse reactions in the two groups was statistically analyzed. Results The HR level and MAP level in the Observation Group at T1,T2, T3 and T4(P<0.01 or 0.05), and the blood glucose and serum cortisol concentration in the Observation Group at T1, T2,T3, T4 and T5 were significantly lower than those of the Control Group(P<0.01 or 0.05). The incidence of adverse reactions in the Observation Group was significantly lower than that in the Control Group(P<0.05). Conclusion Dex-assisted cervical plexus block combined with general anesthesia can stabilize the hemodynamics of patients undergoing thyroid surgery, and reduce the degree of stress response and the incidence of adverse reactions.

关 键 词：右美托咪定 甲状腺 血流动力学 应激反应 不良反应 

分 类 号：R614[医药卫生—麻醉学]