颈浅丛神经阻滞对全麻甲状腺手术患者复苏质量及炎症反应的影响  

Influence of superficial cervical plexus block on the quality of resuscitation and inflammatory response in patients undergoing general anesthesia for thyroid surgery

作　　者：武红会 郑曼[1] 田伟千[1] 姜慧丽[1] 崔耀梅[1] 杨光[1,2] WU Hong-hui;ZHENG Man;TIAN Wei-qian;JIANG Hui-li;CUI Yao-mei;YANG Guang(Department of Anesthesiology,the Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing210029,China;Jiangsu Province Key Laboratory of Anesthesiology,Xuzhou Medical University,Jiangsu Province,Xuzhou221004,China)

机构地区：[1]南京中医药大学附属医院麻醉科,江苏南京210029 [2]徐州医科大学江苏省麻醉学重点实验室,江苏徐州221004

出　　处：《中国当代医药》2021年第32期150-153,共4页China Modern Medicine

基　　金：江苏省重点实验室开放课题资助项目(XZSYSKF2019025)。

摘　　要：目的探讨颈浅丛神经阻滞(SCPB)对全麻甲状腺手术患者复苏质量及炎症反应的影响。方法回顾性选取2020年3月至11月南京中医药大学附属医院收治的201例需行甲状腺外科手术患者为研究对象,根据是否行超声引导下双侧SCPB分为SCPB组(82例)和非SCPB组(119例)。比较两组的手术时间、术中出血量,术前及术后6 h血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)水平,术中丙泊酚、舒芬太尼及瑞芬太尼用量,麻醉恢复室(PACU)患者自主呼吸恢复时间、拔除气管导管时间、PACU停留时间,术后24 h视觉模拟评分法(VAS)评分、恶心与呕吐(PONV)情况。结果两组患者的手术时间、术中出血量比较,差异无统计学意义(P>0.05)。SCPB组术中丙泊酚、舒芬太尼及瑞芬太尼用量低于非SCPB组,差异有统计学意义(P<0.05)。SCPB组患者的自主呼吸恢复时间、拔除气管导管时间早于非SCPB组,SCPB组患者的PACU停留时间短于非SCPB组,差异有统计学意义(P<0.05)。SCPB组术后的IL-1β、IL-6及TNF-α水平均低于非SCPB组,差异有统计学意义(P<0.05)。术后24 h,SCPB组的VAS评分及PONV总发生率低于非SCPB,差异有统计学意义(P<0.05)。结论超声引导下双侧颈浅丛神经阻滞能够改善全麻甲状腺手术患者的复苏质量,减少术中麻醉药物用量,减轻术后24 h疼痛,减少术后24 h PONV发生率,术后炎症反应降低。Objective To investigate the influence of superficial cervical plexus block(SCPB)on the resuscitation quality and inflammatory response of patients undergoing thyroid surgery under general anesthesia.Methods A total of 201 patients requiring thyroid surgery in Affiliated Hospital of Nanjing University of Chinese Medicine from March to November 2020 were retrospectively selected as the study subjects.According to whether bilateral ultrasound-guided SCPB was performed,the patients were divided into SCPB group(82 cases)and non-SCPB group(119 cases).Operation time,intraoperative blood loss,serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)levels,intraoperative dosage of propofol,sufentanil and remifentanil,recovery time of spontaneous breathing of patients in anesthesia recovery room(PACU),time of tracheal tube removal and PACU retention time,visual analogue scale(VAS)score and condition of post operative nausea and vomitting(PONV)at 24 h postoperatively were compared between the two groups.Results There were no significant differences in operative time and intraoperative blood loss between the two groups(P>0.05).The intraoperative dosage of propofol,sufentanil and remifentanil in SCPB group was lower than that in non-SCPB group,the difference was statistically significant(P<0.05).The recovery time of spontaneous breathing and the time of tracheal tube removal were earlier in SCPB group than in non-SCPB group,and the PACU residence time was shorter in SCPB group than in non-SCPB group,the differences were statistically significant(P<0.05).The levels of IL-1β,IL-6 and TNF-αin SCPB group were lower than those in non-SCPB group,the differences were statistically significant(P<0.05).24 h after surgery,VAS score and PONV incidence in SCPB group were lower than those in non-SCPB group,the differences were statistically significant(P<0.05).Conclusions Ultrasound-guided bilateral superficial cervical plexus block could improve the quality of resuscitation in patients undergoing general an

关 键 词：复苏质量 甲状腺手术 颈浅丛神经阻滞 炎症反应 

分 类 号：R614.4[医药卫生—麻醉学]