超声引导下喉上神经阻滞在老年全身麻醉手术气管插管中的应用效果  

Effect of ultrasound-guided superior laryngeal nerve block in endotracheal intubation during geriatric general anesthesia surgery

作　　者：李翠文 苗渝奇 汪惠文 LI Cui-wen;MIAO Yu-qi;WANG Hui-wen(Department of Anesthesia,the 940th Hospital of the Joint Support Force of PLA,Lanzhou Gansu 730050,China;Intensive Care Unit,Second People's Hospital of Gansu Province,Lanzhou Gansu 730000,China)

机构地区：[1]中国人民解放军联勤保障部队第九四〇医院麻醉科,甘肃兰州730050 [2]甘肃省第二人民医院重症医学科,甘肃兰州730000

出　　处：《局解手术学杂志》2025年第3期219-223,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：甘肃省自然科学基金(21JR11RA007)。

摘　　要：目的评估超声引导下喉上神经阻滞(SLNB)在老年全身麻醉气管插管中的应用效果。方法选择择期行全身麻醉手术老年患者40例,按随机数字表法将患者分为观察组(超声引导下SLNB)及对照组(未行任何局部麻醉)。比较2组患者在插管前(T0)及插管后1 min(T1)、5 min(T2)、15 min(T3)的平均动脉压(MAP)、心率(HR)、血糖及肾上腺素、去甲肾上腺素、皮质醇浓度;比较2组患者拔管后30 min、24 h咽喉痛、声音嘶哑发生情况。结果在T1、T2、T3时刻,观察组患者的MAP、HR均低于对照组(P<0.05)。在T1时,观察组患者的血糖、皮质醇浓度低于对照组(P<0.05)。在T1、T2、T3时刻,观察组患者血清中肾上腺素、去甲肾上腺素浓度低于对照组(P<0.05);观察组患者在拔管后30 min及24 h时咽喉痛发生率均低于对照组(P<0.05)。在拔管后30 min时观察组患者声音嘶哑发生率高于对照组(P<0.05);在拔管后24 h时观察组患者声音嘶哑发生率低于对照组(P<0.05)。结论超声引导下SLNB临床效果更好,可有效改善气管插管引起的应激反应,减少插管并发症。Objective To evaluate the effect of ultrasound-guided superior laryngeal nerve block(SLNB)in endotracheal intubation during geriatric general anesthesia surgery.Methods A total of 40 elderly patients scheduled for elective general anesthesia surgery were selected,and randomly divided into the observation group(with ultrasound-guided SLNB)and the control group(without any local anesthesia).The mean arterial pressure(MAP),heart rate(HR),blood glucose,and concentrations of epinephrine,norepinephrine,and cortisol before intubation(T0),and 1 minute(T1),5 minutes(T2),and 15 minutes(T3)after intubation were compared between the two groups.The incidences of sore throat and hoarseness 30 minutes and 24 hours after extubation were compared between the two groups.Results The MAP and HR at T1,T2,and T3 of the observation group were significantly lower than those of the control group(P<0.05).The blood glucose and cortisol at T1 of the observation group were significantly lower than those of the control group(P<0.05).The serum concentrations of epinephrine and norepinephrine at T1,T2 and T3 in the observation group were lower than those in the control group(P<0.05).The incidences of sore throat 30 minutes and 24 hours after extubation in the observation group were lower than those in the control group(P<0.05).The incidence of hoarseness 30 minutes after extubation in the observation group was higher than that in the control group(P<0.05);the incidence of hoarseness 24 hours after extubation in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided SLNB has good clinical effect,which can effectively improve the stress response caused by endotracheal intubation and reduce intubation-related complications.

关 键 词：超声 喉上神经阻滞 气管插管 应激反应 老年 

分 类 号：R614.31[医药卫生—麻醉学]