超声引导下颈神经通路阻滞用于清醒患者颈内静脉置管的效果  

Effect of ultrasound guided cervical nerves pathway block for internal jugular vein cannulation in awake patients

作　　者：余利[1] 王瑾[2] 尤兰英 周达磊 谢力 孙杰 郑康 YU Li;WANG Jin;YOU Lanying;ZHOU Dalei;XIE Li;SUN Jie;ZHENG Kang(Department of Anesthesiology,Nanjing Pukou District Hospital of Chinese Medicine,Nanjing,Jiangsu 211800,China;不详)

机构地区：[1]南京市浦口区中医院麻醉科,江苏南京211800 [2]东南大学附属中大医院麻醉科,江苏南京210000 [3]南京医科大学第四附属医院麻醉科,江苏南京210031

出　　处：《中国临床研究》2024年第2期271-274,共4页Chinese Journal of Clinical Research

基　　金：江苏省医学会麻醉医学科研专项资金项目[SYH-32021-0042(2021037)]。

摘　　要：目的研究超声引导下颈神经通路阻滞(cervical nerves pathway block,CNPB)对颈内静脉穿刺置管患者术中及术后疼痛和舒适度的影响。方法选择南京市浦口区中医院2021年6月至12月择期行颈内静脉穿刺置管的100例患者,按照随机数字表法分为两组:超声引导下CNPB组(B组)50例和局部浸润麻醉组(C组)50例。两组均在超声引导下行颈内静脉置管。主要观察时点为置管操作前(T0)、置管操作中(T1)、操作后5 min(T2)、术后当晚(T3)、术后1 d(T4)、术后2 d(T5)。结局指标为患者颈内静脉置管术中及术后疼痛评分(NRS),舒适度评分(BCS)、血流动力学参数、睡眠质量等,同时记录两组不良事件发生情况。结果B组在T1和T3时点NRS疼痛评分低于C组;在T1、T2、T3和T4时点颈部BCS舒适度评分优于C组;在T1时点心率及收缩压低于C组;在T3和T4时点睡眠质量优于C组,差异有统计学意义(P<0.05)。结论超声引导下CNPB在清醒患者颈内静脉穿刺置管术中及术后当晚的镇痛效果显著优于传统局部浸润麻醉,同时能有效改善患者术后的颈部不适感,改善患者术后当晚的睡眠质量。Objective To evaluate ultrasound guided cervical nerves pathway block(CNPB)for internal jugular vein cannulation in awake patients.Methods A total of 100 patients who underwent elective jugular vein puncture and catheterization at Nanjing Pukou District Hospital of Chinese Medicine from June to December 2021 were selected and divided into ultrasound guided CNPB group(group B,n=50)and local infiltration anesthesia group(group C,n=50).Both groups underwent internal jugular vein catheterization under ultrasound guidance.The outcome indicators were the Numeric Rating Scales(NRS),Bruggrmann Comfort Scale(BCS),hemodynamic parameters,sleeping quality,and the complications.The results were recorded in the morning of the cannulation operation(T0),during the operation(T1),5 min after the cannulation(T2),that night of the cannulation(T3),postoperative day 1(T4),postoperative day 2(T5).Results The NRS of group B were significantly lower than that of group C at T1 and T3.The BCS of group B were higher than group C at T1,T2,T3,and T4.The heart rate and systolic blood pressure at T1 in group B were dramatically lower than group C.At T3 and T4,sleeping quality of group B was better than group C(P<0.05).Conclusion Ultrasound guided CNPB,as the anesthesia for internal jugular vein cannulation in awake patients,can effectively reduce the NRS scaling and improve the BCS and sleeping quality without obvious adverse reactions.

关 键 词：超声引导 颈神经通路阻滞 颈内静脉穿刺置管 镇痛 局部浸润麻醉 

分 类 号：R614.4[医药卫生—麻醉学]