超声引导下颈部迷走神经阻滞预防眼心反射的临床研究  

Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex

作　　者：张琦玮 李洪超 宁林 毛庆祥 闫红 ZHANG Qi-wei;LI Hong-chao;NING Lin;MAO Qing-xiang;YAN Hong(Department of Anesthesiology,Daping Hospital ofArmy Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院麻醉科,重庆400042

出　　处：《局解手术学杂志》2024年第9期815-819,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：重庆市自然科学基金项目(cstc2019jcyj-msxmX0018)。

摘　　要：目的观察超声引导下颈部迷走神经阻滞(CVB)对眼心反射的预防效果。方法招募行巩膜后兜带术或眼球摘除术的患者86例,随机分为全麻组和复合麻醉组。2组患者入室后均进行常规全身麻醉诱导插管,复合麻醉组另采用1%利多卡因在超声引导下行右侧CVB。记录2组患者术中心率、血压、血氧饱和度、阿托品使用情况和手术操作情况;比较2组患者术后舒适度、声音嘶哑及神经阻滞相关并发症发生情况。结果与全麻组比较,复合麻醉组患者使用阿托品占比、暂停手术操作占比明显降低(P<0.05),眼心反射发生率、眼心反射发生级别明显降低(P<0.05);复合麻醉组患者声音嘶哑发生率高于全麻组,差异有统计学意义(P<0.05);复合麻醉组患者未发生神经阻滞相关并发症。结论超声引导下右侧CVB用于眼科手术能安全有效地抑制眼心反射的发生。Objective To observe the preventive effect of ultrasound-guided cervical vagus nerve block(CVB)in preventing oculocar‐diac reflex.Methods A total of 86 patients who underwent posterior scleral reinforcement or ophthalmectomy were recruited and randomly divided into the general anesthesia group and the composite anesthesia group.After admission,patients in the two groups underwent conven‐tional general anesthesia induction intubation,and the composite anesthesia group received another 1%lidocaine for right CVB under ultrasound guidance.The heart rate,blood pressure,saturation of peripheral oxygen,atropine usage and surgical procedures of the two groups were recorded.Postoperative comfort degree,hoarseness and complications related to nerve block were compared between the two groups.Results Compared with the general anesthesia group,the proportion of patients using atropine and the proportion of suspending operation in the composite anesthesia group were significantly reduced(P<0.05),and the incidence of oculocardiac reflex and the level of oculocardiac reflex were significantly decreased(P<0.05).The incidence of hoarseness in the composite anesthesia group was higher than that in the general anesthesia group,and the difference was statistically significant(P<0.05).There was no complication related to nerve block occurred in the composite anesthesia group.Conclusion In ophthalmic surgery,ultrasound-guided right CVB can safely and effec‐tively inhibit the occurrence of oculocardiac reflex.

关 键 词：超声引导 迷走神经阻滞 眼心反射 并发症 

分 类 号：R614.2[医药卫生—麻醉学]