超声引导下不同剂量利多卡因星状神经节阻滞对腹腔镜胆囊切除术患者血流动力学的影响  

Effect of ultrasound-guided stellate ganglion block with different doses of lidocaine on hemodynamics in patients undergoing laparoscopic cholecystectomy

作　　者：苗永明 杨红飞 黄赛赛[2] MIAO Yongming;YANG Hongfei;HUANG Saisai(Department of Anesthesiology,Nantong Tongzhou District People's Hospital,Nantong 226300,China;不详)

机构地区：[1]南通市通州区人民医院麻醉科,江苏南通226300 [2]南通大学附属医院麻醉科,江苏南通226300

出　　处：《中国处方药》2025年第6期71-74,共4页Journal of China Prescription Drug

摘　　要：目的探讨超声引导下不同剂量利多卡因星状神经节阻滞(SGB)对腹腔镜胆囊切除术患者血流动力学的影响。方法选取2021年8月~2024年8月南通市通州区人民医院行超声引导下星状神经节阻滞腹腔镜胆囊切除术患者共100例,随机分为A组33例、B组33例和C组34例,依次给予1%利多卡因7 ml、5 ml、3 ml。比较三组阻滞成功率,血流动力学和脑血流动力学变化,麻醉效果,临床时间指标及不良反应。结果三组阻滞成功率差异无统计学意义(P>0.05);A组气管插管时(T1)的平均动脉压(MAP)低于B组和C组,气腹建立时(T2)、拔管后苏醒时(T4)的MAP低于C组;A组T1、T4时的心率(HR)低于B组和C组,T2时的HR低于C组;A组T1、T2、T4时心率与收缩压乘积(RPP)低于B组和C组(P<0.05);A组T1、T2时的平均血流速度(Vm)低于B组和C组,T4时的Vm低于C组;A组T1、T2、T4时的搏动指数(PI)、阻力指数(RI)低于B组和C组(P<0.05);三组麻药起效时间、拔管时间、自主呼吸恢复时间、肠鸣音恢复时间、排气时间比较:A组<B组<C组(P<0.05);术后3 d,三组疼痛视觉模拟评分(VAS)及改良警觉-镇静(MOAAS)评分较术前均升高(P<0.05),三组术后3 d VAS和MOAAS评分差异无统计学意义(P>0.05);A组不良反应发生率(3.03%)低于B组(24.24%)、C组(29.41%)(P<0.05)。结论超声引导下不同剂量(7 ml、5 ml、3 ml)利多卡因SGB均能满足腹腔镜胆囊切除术手术需求,但7 ml 1%利多卡因的脑血流动力学稳定性优于5 ml、3ml,且不良反应更少,有利于患者快速苏醒和恢复。Objective To investigate the effect of ultrasound-guided stellate ganglion block(SGB)with different doses of lidocaine on hemodynamics in patients undergoing laparoscopic cholecystectomy.Methods A total of 100 patients undergoing ultrasound-guided stellate ganglion block laparoscopic cholecystectomy in the Nantong Tongzhou District People's Hospital from August 2021 to August 2024 were randomly divided into group A(n=33),group B(n=33)and group C(n=34),which were given 1%lidocaine 7 ml,5 ml and 3 ml in turn.The success rate of block,hemodynamic and cerebral hemodynamic changes,anesthesia effect,clinical time index and adverse reactions were compared among the three groups.Results There was no significant difference in the success rate of block among the three groups(P>0.05).The mean arterial pressure(MAP)at tracheal intubation(T1)in group A was lower than that in group B and group C,and the MAP at the establishment of pneumoperitoneum(T2)and recovery after extubation(T4)was lower than that in group C;the heart rate(HR)at T1 and T4 in group A was lower than that in group B and group C,and the HR at T2 was lower than that in group C;the rate-pressure product(RPP)at T1,T2 and T4 in group A was lower than that in group B and group C(P<0.05).The mean blood flow velocity(Vm)at T1,and T2 in group A was lower than that in group B and group C,and the Vm at T4 was lower than that in group C;the pulsatility index(PI)and resistance index(RI)at T1,T2 and T4 in group A were lower than those in group B and group C(P<0.05).Comparison of the onset time of anesthesia,extubation time,spontaneous respiration recovery time,bowel sound recovery time,and flatus time among the three groups:Group A<Group B<Group C(P<0.05).At 3 days after operation,the visual analogue scale(VAS)and modified alertness-sedation scale(MOAAS)scores of the three groups were higher than those before operation(P<0.05).There was no significant difference in VAS and MOAAS scores between the three groups at 3 days after operation(P>0.05).The incidence of adverse rea

关 键 词：超声引导 血流动力学 利多卡因 腹腔镜胆囊切除术 星状神经节阻滞 

分 类 号：R61[医药卫生—外科学]