神经刺激仪颈丛麻醉行腔镜甲状腺手术的应用

目的神经刺激仪引导双侧颈丛阻滞术在腔镜下甲状腺手术中的临床应用。方法择期行甲状腺手术的患者60例,ASAⅠ～Ⅱ级,均无甲状腺功能亢进、高血压和心脑血管病病史等颈丛阻滞的禁忌证。随机分为神经刺激仪引导颈丛阻滞术麻醉组（A组）和常规颈丛阻滞术麻醉组（B组）,以视觉模拟评分法（VAS）评价两组麻醉效果,记录两组患者的麻醉并发症。结果两组患者麻醉后VAS评分有显著性差异,A组在切皮、甲状腺上极及峡部分离、缝皮时麻醉效果均优于B组（P〈0.01）,且麻醉并发症发生率明显降低。结论神经刺激仪引导应用于颈丛阻滞术麻醉可以改善麻醉效果,减少麻醉并发症,提高麻醉安全性,降低麻醉费用,还可适应于门诊日间颈部手术的应用。

Application of Nerve Stimulator Guiding Bilateral Cervical Plexus Block in Endoscopic Thyroidectomy

Objective To explore the clinical application of nerve stimulator guiding bilateral cervical plexus block in endoscopic thyroidectomy.Methods Sixty ASA Ⅰ-Ⅱ patients without any contraindications such as hyperthyroidism,hypertension,cardio-cerebrovascular diseases and scheduled for thyroidectomy of levels were chose.They were randomly divided into two groups;group A received nerve stimulator guiding bilateral cervical plexus block and group B received the conventional cervical plexus anesthesia.The anesthetic effects of the two groups were assessed by using visual analogue scale（VAS）.The complications of anesthesia were recorded.Results The difference in VAS scores after anesthesia were significant between the two group.The group A had a better anesthesia effect in cutting skin,isolating the upper pole and isthmus of thyroid gland and sewing skin as compared with the group B;while the group A had a lower incidences of anesthesia complications（P0.01）.Conclusion Application of nerve stimulator in cervical plexus block can improve anesthetic effect and safety,reduce anesthesia complications and anesthesia expenses,and can be adapted to the outpatient daytime neck surgery.