超声引导下C_(4)神经根阻滞复合全身麻醉在甲状腺手术中的应用  

Application of C4 Nerve Root Block under Ultrasound Guidance Combined with General Anesthesia in Thyroid Surgery

作　　者：李加宾 林建[1] 张文清 徐三荣 LI Jiabin;LIN Jian;ZHANG Wenqing;XU Sanrong(Zhangzhou City Hospital,Zhangzhou 363000,China;不详)

机构地区：[1]漳州市医院,福建漳州363000

出　　处：《中外医学研究》2023年第28期145-148,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下C_(4)神经根阻滞复合全身麻醉在甲状腺手术中的应用。方法:回顾性分析2021年1月—2022年6月漳州市医院收治的121例甲状腺手术患者资料。根据不同麻醉方法将其分为A组(41例)、B组(40例)、C组(40例)。三组均给予全身麻醉,A组给予颈丛神经阻滞复合全身麻醉,B组给予超声引导下C_(4)神经根阻滞复合全身麻醉。比较三组术前、切皮时、拔管时、术后30 min平均动脉压(MAP)和心率(HR),麻醉药用量,术后30 min、24 h的疼痛程度及并发症。结果:切皮时、拔管时、术后30 min,C组MAP、HR均高于A组、B组,差异有统计学意义(P<0.05)。A组、B组丙泊酚用量、瑞芬太尼用量均少于C组,B组丙泊酚用量、瑞芬太尼用量均少于A组,差异有统计学意义(P<0.05)。B组术后30 min、24 h NRS评分明显低于A组、C组,A组术后24 h NRS评分低于C组,差异有统计学意义(P<0.05)。A组声音嘶哑和呼吸困难发生率均高于B组,C组恶心呕吐发生率高于A组、B组,B组、C组呼吸困难发生率低于A组,差异有统计学意义(P<0.05)。结论:超声引导下C_(4)神经根阻滞复合全身麻醉效果确切,并发症少,有利于患者术后早日康复。Objective:To explore the application of C_(4)nerve root block under ultrasound guidance combined with general anesthesia in thyroid surgery.Method:The data of 121 patients undergoing thyroid surgery admitted to Zhangzhou City Hospital from January 2021 to June 2022 were retrospectively analyzed.According to different anesthesia methods,they were divided into group A(41 cases),group B(40 cases)and group C(40 cases).All three groups were given general anesthesia,group A was given cervical plexus nerve block combined with general anesthesia,group B was given C_(4)nerve root block under ultrasound guidance combined with general anesthesia.The mean arterial pressure(MAP),heart rate(HR)before surgery,at skin incision,at extubation,and 30 minutes after surgery,anesthetic drug dosage,pain degree at 30 min and 24 h after surgery,complications were compared among the three groups.Result:MAP and HR in group C were higher than those in group A and group B at skin incision,at extubation,and 30 minutes after surgery,and the differences were statistically significant(P<0.05).The dosage of Propofol and Remifentanil in group A and B were less than those in group C,and the dosage of Propofol and Remifentanil in group B were less than those in group A,and the differences were statistically significant(P<0.05).NRS scores at 30 min and 24 h after surgery in group B were significantly lower than those in group A and group C,24 h NRS score of group A was lower than that of group C,and the differences were statistically significant(P<0.05).The incidence of sound hoarseness and dyspnea in group A was higher than that in group B,the incidence of nausea and vomiting in group C was higher than that in group A and group B,and the incidences of dyspnea in group B,group C were lower than that in group A,and the differences were statistically significant(P<0.05).Conclusion:C_(4)nerve root block under ultrasound guidance combined with general anesthesia has a definite anesthesia effect and low complications,which is beneficial for patients to re

关 键 词：超声引导 神经根阻滞 甲状腺手术 

分 类 号：R614[医药卫生—麻醉学]