耳穴注射配合表面麻醉用于鼻内镜手术效果观察

目的:观察表面麻醉配合耳穴注射用于鼻内镜手术的麻醉效果.方法:选择美国麻醉医师协会健康分级(ASA)Ⅰ-Ⅱ级手术患者40例,随机分为耳穴配合表面麻醉组(A组)和单纯表面麻醉组(B组),每组20例.两组患者双侧鼻腔均采用1%丁卡因30 mL加0.1%肾上腺素2 mL浸润的棉片进行表面麻醉2次,其中A组患者在表面麻醉前,在双耳神门、外鼻穴皮下各注射维生素B1注射液0.1 mL,10 min后开始手术,术中不再加用任何麻醉药.术中根据患者血压、心率变化和对疼痛的反应酌情静脉给予小剂量血管活性药和芬太尼.结果:A组麻醉优良率(90.0%)与B组(75.0%)相比,差异有统计学意义(P<0.05);A组术中使用止痛药和血管活性药的比例明显少于B组.结论:耳穴注射配合表面麻醉用于鼻内镜手术具有良好的麻醉效果.

Clinical observation on effect of auricular point injection combined with superficial anesthesia for nasal endoscopy surgery

Objective To observe the anesthetic effect of combined superficial anesthesia and auricular point injection for nasal endoscopy surgery. Methods Forty cases of grade I-II as ASA for nasal endoscopy surgery were randomly divided into a combined auricular point injection and superficial anesthesia group (group A) and a simple superficial anesthesia group (group B), 20 cases in each group. Both groups accepted superficial anesthesia 2 times on the bilateral nasal cavities with cotton pieces that was immersed in the mixed solution of 1% Tetracaine 30 mL and 0. 1% Adrenaline 2 mL. In group A, bilateral auricular points of Shenmen and Waibi (externol nose) were injected with 0. 1 mL Vitamin B_1 solution before the superficial anesthesia. After 10 min of observation, surgery was carried out. During the surgery, the patients only accepted a small amount of vasoactive substance and Fentanyl according to the changes of patient's blood pressure, heart rate and pain feeling. Results The total effective rate of 90. 0% in the group A was significantly better than 75. 0% in the group B (P<0. 05). The rate of using analgetic and vasoactive substance in the group A was obviously less than that of the group B. Conclusion Combined auricular point injection and superficial anesthesia has good anesthetic effect for nasal endoscopy surgery.