喉上神经内支阻滞对栓塞治疗的颅内多发动脉瘤病人全麻苏醒期恢复质量的影响

目的 探讨喉上神经内支（ibSLN）阻滞对栓塞治疗的颅内多发动脉瘤（MIA）病人全麻苏醒期恢复质量的影响。方法 回顾性分析2016年7月至2019年9月栓塞治疗的100例MIA的临床资料。麻醉恢复期，50例超声引导下注射利多卡因3 ml进行ibSLN阻滞（观察组），50例按常规苏醒流程复苏（对照组）。结果 与手术结束时（T1）相比，两组气管插管拔管后即刻（T2），拔管后5（T3）、10（T4）、15 min（T5）及出手术室时（T6）心率（HR）、平均动脉压（MAP）均显著增高（P<0.05），T2时刻最高，随后呈下降趋势。观察组T2、T3、T4、T5、T6时刻MAP和HR均明显低于对照组（P<0.05）。与对照组比较，观察组气管导管留置阶段咳嗽评分、气管导管耐受评分、拔管时不良记忆评分均显著降低（P<0.05），拔管时间明显缩短（P<0.05），咽痛发生率以及镇静药物使用率均显著降低（P<0.05），但声音嘶哑发生率明显增高（P<0.05）。结论 超声引导下ibSLN阻滞可明显改善栓塞治疗的MIA病人全麻苏醒期恢复质量。

Effect of ultrasound-guided internal branch of the upper laryngeal nerve block on general anesthetic recovery of patients with multiple intracranial aneurysms after interventional embolization

Objective To explore the effect of ultrasound-guided internal branch of the upper laryngeal nerve block(USG-guided iSLN block)on the recovery quality of the patients with multiple intracranial aneurysms(MIA)during the general anesthetic recovery period.Methods The clinical data of 100 patients with MIA who were treated with embolization from July 2016 to September 2019 were analyzed retrospectively.During the recovery period of anesthesia,50 patients received injection of 3 ml lidocaine under ultrasound guidance for ibSLN block(observation group)and 50 patients received the routine recovery process(control group).Results Compared with the heart rate(HR)and mean arterial pressure(MAP)at end of the operation(T1),the HR and MAP significantly increased immediately after the extubation(T2),5 minutes after the extubation(T3),10 minutes after the extubation(T4),15 minutes after the extubation(T5)and exiting the operating room(T6)in both groups(P<0.05).The MAP and HR were significantly lower in the observation group at T2,T3,T4,T5,and T6 than the control group(P<0.05).The cough score,endotracheal tolerance score,and poor memory score at the time of extubation significantly reduced,the extubation time significantly decreased,and the incidence of sore throat and the use of sedative drugs significantly reduced,and the incidence of hoarseness significantly increased in the observation group compared with the control group(P<0.05).Conclusion USG-guided iSLN block can reduce the adverse reactions during the recovery period and improve the recovery quality of the patients with MIA after interventional embolization.