单次星状神经节阻滞对甲状腺手术患者局部脑氧饱和度及术后恶心呕吐的影响  

Effect of Single Stellate Ganglion Block on Regional Cerebral Oxygen Saturation and Postoperative Nausea and Vomiting in Patients Undergoing Thyroid Surgery

作　　者：毛一群[1] 程影 MAO Yi-qun;CHENG Ying(Department of Anesthesiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院麻醉科,江苏苏州215006

出　　处：《中国血液流变学杂志》2022年第4期558-561,共4页Chinese Journal of Hemorheology

摘　　要：目的观察超声引导下单次星状神经节阻滞(stellate ganglion block,SGB)对甲状腺手术患者局部脑氧饱和度及术后恶心呕吐(postoperative nausea and vomiting,PONV)的影响。方法选取全麻下行甲状腺肿瘤切除术的患者。采用随机数字表法,将患者分为两组:A组注射1%利多卡因5 mL(n=60);B组注射0.9%生理盐水5 mL(n=60),两组患者均于麻醉诱导前在超声引导下行右侧SGB,术中记录患者额前局部脑氧饱和度变化,手术结束前予以盐酸托烷司琼5 mg静脉推注。手术结束后观察患者24 h内恶心与呕吐症状的发生率及严重程度,并记录入室后(T0)、SGB阻滞后5 min(T1)、麻醉诱导后5 min(T2)、SGB后30 min(T3)、拔管即时(T4)、术后6 h(T5)的平均动脉压(MAP)、心率(HR)等变化情况。结果与B组比较,A组PONV发生率及程度均降低,差异具有统计学意义(P<0.05);两组患者局部脑氧、MAP、HR之间差异无统计学意义(P>0.05)。结论单次SGB对患者术中局部脑氧无明显影响,降低了甲状腺手术患者术后PONV发生率。Objective To observe the effect of ultrasound-guided single stellate ganglion block(SGB)on postoperative nausea and vomiting(PONV)and regional cerebral oxygen saturation in patients undergoing thyroid surgery.Methods Patients undergoing thyroid neoplasm under general anesthesia were selected.Patients were divided into two groups by random number table method:Group A(5 mL of 1%lidocaine)(n=60)and Group B(0.9%normal saline 5 mL)(n=60).Before anesthesia induction,patients in both groups underwent right SGB under ultrasound guidance,the changes of regional cerebral oxygen saturation were recorded during operation,and tropisetron hydrochloride 5 mg was injected intravenously before the end of operation.The incidence and severity of nausea and vomiting within 24 hours after operation were observed,the changes of mean arterial pressure(MAP)and heart rate(HR)were recorded under quiet state(T0),5 minutes after SGB blockade(T1),5 minutes after anesthesia induction(T2),30 minutes after SGB(T3),immediate extubation(T4),and 6 hours after operation(T5).Results Compared with group B,the incidence and degree of PONV in group A were reduced,and the difference was statistically significant.There was no statistical difference of regional cerebral oxygen,MAP and HR between the two groups.Conclusion Single SGB has no significant effect on local cerebral oxygen and reduces the incidence of PONV after thyroid surgery.

关 键 词：甲状腺 星状神经节 局部脑氧饱和度 术后恶心呕吐 

分 类 号：R614.2[医药卫生—麻醉学] R736.1[医药卫生—外科学]