穴位镇痛对颈丛阻滞下甲状腺切除术麻醉效果的影响

目的 探讨甲状腺手术中穴位镇痛对颈丛阻滞的麻醉效果及心血管反应的影响.方法 拟行甲状腺手术患者40例,随机分为对照组(A组)和观察组(B组),每组20例.在0.375％布比卡因颈丛阻滞下,B组则在切皮前10 min于两侧合谷穴分别注入含哌替啶50 mg的5％葡萄糖溶液4 ml,共8 ml.结果 与麻醉前相比,两组麻醉后SBP、DBP和HR均上升(P＜0.01或P＜0.05)；与A组相比,B组麻醉后SBP、DBP和HR较低；麻醉效果B组明显优于A组(P＜0.01).结论 穴位镇痛可增强颈丛阻滞的麻醉效果,减轻术中甲状腺和气管的牵拉反应,抑制颈丛阻滞的心血管反应.

Influences of acupoint analgesia on the anesthetic efficacy of cervical plexus block in patients undergoing thyroidectomy

Objective To explore the influences of acupoint analgesia on the anesthetic efficacy of cervical plexus block and the cardiovascular reaction in patients during thyroidectomy. Methods Forty patients undergoing selective thyroidectomy were randomly divided into two groups with 20 cases in each. Cervical plexus block was performed with 0. 375% bupivacaine. The patients were received mixture of pethidine 50 mg and 5% glucose solution 4 ml into HoKu acupoint of both sides with total dose 8 ml in group B. Results Compared with preanesthesia, SBP,DBP and HR were significantly increased in group A and B after anesthesia （P〈0.01 or P〈0.05） The analgesic effect in group B was better than that in group A （P〈0.01）. Conelusion Acupoint analgesia can strengthen the anesthetic efficacy of cervical plexus block, relieve the traction reflex, and depress the circulatory reaction of cervical plexus block during thyroidectomy.