超声引导下双侧喉上神经阻滞复合静脉全麻对甲状腺癌患者围术期应激反应的影响  

Effect of Ultrasound Guided Bilateral Superior Laryngeal Nerve Block Combined with Intravenous General Anesthesia on Perioperative Stress Response in Patients with Thyroid Cancer

作　　者：郑英迎 徐鹏 ZHENG Yingying;XU Peng(The First People's Hospital of Pingdingshan,Pingdingshan,467000)

机构地区：[1]河南省平顶山市第一人民医院,467000

出　　处：《实用癌症杂志》2024年第8期1272-1275,共4页The Practical Journal of Cancer

摘　　要：目的探究超声引导下双侧喉上神经阻滞复合静脉全麻对甲状腺癌根治术患者围术期应激反应的影响。方法该研究为一项前瞻性研究,将84例行甲状腺癌根治术治疗的患者纳入此研究,采用随机数字表法分为2组,各42例。对照组行常规静脉全麻,观察组行超声引导下双侧喉上神经阻滞复合静脉全麻。比较2组患者麻醉诱导前30 min、插管时、拔管时血流动力学指标[心率(HR)、平均动脉压(MAP)]及应激反应指标[肾上腺素(E)、去甲肾上腺素(NE)];比较2组麻醉苏醒后3 h、12 h、24 h时疼痛程度[采用视觉模拟评分法(VAS)评估]及术后72 h内麻醉不良反应发生情况。结果麻醉诱导前30 min、插管时、拔管时2组HR、MAP均有所升高,但与对照组比较,观察组插管时、拔管时HR、MAP较低(P<0.05)。麻醉诱导前30 min、插管时、拔管时2组E、NE水平均升高,但与对照组比较,观察组插管时、拔管时E、NE水平较低(P<0.05)。麻醉苏醒后3 h、12 h、24 h,2组VAS评分均有所升高,但与对照组比较,观察组各时点VAS评分较低(P<0.05)。与对照组比较,观察组术后72 h内麻醉不良反应总发生率较低(P<0.05)。结论超声引导下双侧喉上神经阻滞复合静脉全麻可减轻甲状腺癌根治术患者围术期应激反应,维持血流动力学稳定,提高术后镇痛效果,且有助于减少患者术后麻醉不良反应发生。Objective To investigate the effect of ultrasound guided bilateral superior laryngeal nerve block combined with intravenous general anesthesia on perioperative stress response in patients underwent radical thyroidectomy for thyroid cancer.Methods This study was a prospective study.84 patients who underwent radical thyroidectomy for thyroid cancer were included in this study.They were randomly divided into 2 groups using a random number table method,with 42 patients in each group.The control group received routine intravenous general anesthesia,while the observation group received ultrasound guided bilateral superior laryngeal nerve block combined with intravenous general anesthesia.The hemodynamic indicators[heart rate(HR),mean arterial pressure(MAP)]and stress response indicators[adrenaline(E),norepinephrine(NE)]were compared between the 2 groups of patients 30 minutes before anesthesia induction,during intubation,and during extubation.The pain levels at 3,12,and 24 hours after awakening from anesthesia between the 2 groups[evaluated using visual analogue scale(VAS)]and the occurrence of adverse reactions to anesthesia within 72 hours after surgery were compared.Results The HR and MAP of both groups increased 30 minutes before anesthesia induction,during intubation,and during extubation,but compared with the control group,the HR and MAP of the observation group were lower during intubation and extubation(P<0.05).The levels of E and NE in both groups increased 30 minutes before anesthesia induction,during intubation,and during extubation.However,compared with the control group,the levels of E and NE in the observation group were lower during intubation and extubation(P<0.05).At 3 hours,12 hours,and 24 hours after awakening from anesthesia,the VAS scores of both groups increased,but compared with the control group,the VAS scores of the observation group were lower at all time points(P<0.05).Compared with the control group,the observation group had a lower overall incidence of adverse reactions to anesthesia within

关 键 词：甲状腺癌根治术 静脉全麻 超声引导 喉上神经阻滞 应激反应 

分 类 号：R736.1[医药卫生—肿瘤]