改良的颈神经丛阻滞麻醉的临床观察

目的：探讨甲状腺大部切除手术应用改良的颈神经丛阻滞麻醉效果。方法：全部病例均采用一点法深浅颈神经丛阻滞。将全部病例随机分为A、B两组（每组30例）,深丛均为0.25%布比卡因液或1.14%利多卡因和0.14%地卡因混合液,每侧各约5-6ml。A组为与深丛相同浓度的局麻药液,每侧约8-10ml,B组为与A组所用药同等剂量,但其浓度为A组的2/3（即加入1/3容量的生理盐水）,使浅丛容量较A组增加1/3,约为11-13.5ml。结果：两组病人经过顺利,均无并发症。阻滞效果均较好,但A组病人在手术进行到牵拉甲状腺上极时,有12例病人牵拉痛较明显。结论：低浓度高容量法颈丛阻滞,效果可靠、安全、并发症少,是甲状腺大部切除较理想的麻醉方法。

Clinical observation of ameliorated cervical plexus block

Objective　To evaluate effects on sub-thyroidectomy with anesthesia of ameliorated cervical plexus block.Methods　All patients with deep-superficial plexus block on the only one point were randomly divided into two groups (thirty patients in each group).Deep plexus was administered 0.25% bupivacaine or mixure of 1.14% lidocaine and 0.14% dicaine 5～6ml in each side.In group A,the concentration of the superficial plexus was equal to that of the deep plexus,and the content was 8～10ml.But in group B,the quantity was equal to that of group A,and the concentration was 2/3 of that of group A,and the content was about 11～13.5ml,increased 1/3 than that of group A.Results　The patients in two groups experienced smoothly during operation,without any complication.But twelve patients in group A had uncomfortable pain,when upside thyroid was pulled.Conclusion　Ameliorated cervical plexus block is belived to be ideal anesthetic method of the sub-thyroidectomy because of its certain and safe effect and few complications.