经皮穴位电刺激联合颈丛神经阻滞麻醉在甲状腺手术中的应用研究

目的:观察经皮电刺激合谷、内关穴联合颈丛神经阻滞麻醉在甲状腺手术中的应用效果。方法:将68例行甲状腺手术的患者随机分为观察组和对照组各34例,对照组采用颈丛神经阻滞麻醉,观察组采用经皮电刺激合谷、内关穴联合颈丛神经阻滞麻醉。比较两组麻醉前后平均动脉压和血氧饱和度,以及两组术后麻醉效果、疼痛数字量表(NRS)评分和不良反应情况。结果:两组麻醉后各时点平均动脉压较麻醉前均升高,差异有统计学意义(P<0.05);观察组手术全程血压变化幅度小于对照组,差异有统计学意义(P<0.05)。观察组麻醉前后血氧饱和度无明显变化,差异无统计学意义(P>0.05);对照组麻醉后血氧饱和度低于麻醉前,差异有统计学意义(P<0.05)。两组患者全部麻醉成功,但对照组Ⅲ级麻醉患者比例高于观察组,差异有统计学意义(P=0.001)。观察组术后1 h、4 h、12 h的NRS评分均低于对照组,差异有统计学意义(P<0.001)。观察组不良反应发生率低于对照组,差异有统计学意义(P=0.031)。结论:在甲状腺手术中采用经皮穴位电刺激联合颈丛神经阻滞麻醉,具有麻醉效果好、循环干扰小、并发症少等优点。

Application of Transcutaneous Acupoint Electrical Stimulation Combined with Cervical Plexus Block Anesthesia in Thyroid Surgery

Objective:To observe the effect of applying transcutaneous acupoint electrical stimulation(TAES)to Neiguan acupoint(LI4) and Hegu acupoint(PC6) combined with cervical plexus block in thyroid surgery.Methods:A total of 68 patients undergoing thyroid surgery were randomly divided into treatment group(34 cases) and control group(34 cases). Patients in the control group only received cervical plexus block anesthesia,while patients in the treatment group received TAES to Neiguan acupoint(LI4) and Hegu acupoint(PC6)combined with cervical plexus block anesthesia. The mean arterial pressure and blood oxygen saturation of the two groups before and after anesthesia were compared,and the anesthetic effect,numerical rating scale(NRS) score and adverse reactions of the two groups after surgery were compared. Results:After anesthsia,the mean arterial pressure of the two groups were higher than those before anesthesia(P <0.05). Throughout the operation,the variation in the blood pressure of the treatment group was narrower than that of the control group(P<0.05). The blood oxygen saturation of the treatment group was stable during the operation,without obvious change(P> 0.05),while the blood oxygen saturation of the control group after anesthesia was lower than that before anesthesia(P<0.05). All patients in both groups were successfully anesthetized,but the proportion of patients with grade Ⅲ anesthetic effect in the control group was higher than that in the treatment group(P= 0.001). The NRS scores of the treatment group at 1 h,4 h and 12 h after surgery were lower than those of the control group(P<0.001). The incidence of adverse reactions of the treatment group was lower than that of the control group(P= 0. 031). Conclusion:Applying TAES combined with cervical plexus block anesthesia in thyroid surgery can improve the anesthetic effect,decrease the interfere in blood circulation and reduce the complications.