头皮神经阻滞对神经外科手术患者术后早期康复质量的影响  

Effect of scalp nerve block on the quality of early postoperative recovery in patients undergoing neurosurgery

作　　者：张正辉 廖常莉 冉鑫 曾东[1] 周述芝[1] 段声吉 陈卉[4] ZHANG Zhenghui;LIAO Changli;RAN Xin;ZENG Dong;ZHOU Shuzhi;DUAN Shengji;CHEN Hui(Department of Anesthesiology,Yaan People's Hospital,Yaan 625000,China;Department of Science and Technology,Southwest Med-icd University,Luzhou 646000,China;Department of Anesthesiology,North Sichuan Medical College,Nanchong 637000,China;De-partment of Neurosurgery,Yaan People's Hospital,Yaan 625000,China)

机构地区：[1]雅安市人民医院麻醉科,雅安625000 [2]西南医科大学科技处,泸州646000 [3]川北医学院麻醉学系,南充637000 [4]雅安市人民医院神经外科,雅安625000

出　　处：《西南医科大学学报》2024年第1期58-61,共4页Journal of Southwest Medical University

基　　金：雅安市科技局科研课题(2020yyjskf02);四川省医学会课题(2022KJXM006kyzx)。

摘　　要：目的探讨头皮神经阻滞联合全身麻醉对神经外科手术患者术后早期康复质量的影响。方法选择2020年7月至2022年5月在雅安市人民医院择期全身麻醉下行神经外科手术的患者93例,按麻醉方式分成对照组(45例)与观察组(48例),对照组采用全身麻醉进行手术,观察组行超声引导下头皮神经阻滞联合全身麻醉。观察并记录两组患者术后4、8、12、24 h的视觉模拟评分表(visual analogue scale,VAS)评分,术中镇痛药物使用量,住院时长,麻醉苏醒期躁动以及术后恶心、呕吐的发生率,采用中文版术后恢复质量量表(Quality of Recovery Scale,QoR)评估两组患者术前、术后3、7 d康复质量。结果观察组术后4、8、12、24 h的VSA评分及术中瑞芬太尼用量低于对照组(P<0.05),术后3 d的QoR评分高于对照组(P<0.05),观察组住院时间较对照组更短(P<0.05),观察组苏醒期躁动发生率以及术后恶心、呕吐发生率低于对照组(P<0.05)。结论头皮神经阻滞联合全身麻醉用于神经外科手术患者镇痛效果良好,有利于患者术后早期康复。Objective To observe the effect of scalp nerve block combined with general anesthesia on the quality of early post-operative recovery in patients undergoing neurosurgery.Methods A total of 93 patients who underwent scheduled neurosurgery at Yaan people’s Hospital from July 2020 to May 2022 were divided into a control group(45 cases)and an observation group(48 cases).The control group received general anesthesia,while the observation group received scalp nerve block combined with general anesthesia un-der ultrasound guidance.VSA score at 4,8,12 and 24 hours after the operation were recorded.Intraoperative analgesic drugs usage,length of hospital stay,incidence of agitation during the awakening period,and incidence of postoperative nausea and vomiting were ob-served and recorded in both groups.The Chinese version of the Quality of Recovery Scale(QoR)was used to assess the preoperative and postoperative(at 3 and 7 days)recovery quality in both groups.Results The observation group had lower VSA scores at 4,8,12,and 24 hours postoperatively compared to the control group(P<0.05).The intraoperative remifentanil dosage was also lower in the ob-servation group(P<0.05).The QoR scores at 3 days postoperatively were higher in the observation group(P<0.05).The observation group had a shorter hospital stay(P<0.05)and lower incidence of agitation during the awakening period,as well as postoperative nau-sea and vomiting(P<0.05),compared to the control group.Conclusion Scalp nerve block combined with general anesthesia was ef-fective for analgesia in patients undergoing neurosurgery and facilitated early postoperative recovery.

关 键 词：头皮神经阻滞 全身麻醉 神经外科手术 术后康复 

分 类 号：R614[医药卫生—麻醉学]