星状神经节阻滞对老年患者全麻气管插管应激反应的影响

目的 观察星状神经节阻滞(SGB)对全麻气管插管应激反应的影响.方法 择期全麻手术患者(年龄≥65岁)45例,随机分为三组.左侧SGB组(LS组)、右侧SGB组(RS组)和对照组(C组),每组15例.记录各组麻醉前(T_0)、诱导后(T_1)、插管即刻(T_2)、插管后1 min(T_3)、5 min(T_4)的SBP、DBP、HR的变化,并计算RPP;于T_0、T_1时点抽取患者上肢静脉血,检测促肾上腺素皮质激素(ACTH)、皮质醇(Cor和血糖(BG).结果 与T_0时比较,三组SBP、DBP、MAP及RPP在T_1时均明显降低(P<0.01),C组MAP及RPP在T_2时明显升高(P<0.05),LS组HR及RPP在T2时明屁升高(P<0.05).与RS组比较,C组及LS组RPP在T2时明显升高(P<0.05).C组BG在T_4明显升高(P<0.05).围插管期ACTH和Cor未见明显改变.结论 右侧SGB可有效抑制老年患者全麻气管插管时的心血管反应. _0、T_1时点抽取患者上肢静脉血,检测促肾上腺素皮质激素(ACTH)、皮质醇(Cor和血糖(BG).结果 与T_0时比较,三组SBP、DBP、MAP及 PP在T_1时均明显降低(P<0.01),C组MAP及RPP在T_2时明显升高(P<0.05),LS组HR及RPP在T2时明屁升高(P<0.05).与RS组比较,C组及LS组RPP在T2时明显升高(P<0.05).C组BG在T_4明显升高(P<0.05).围插管期ACTH

Effect of stellite ganglion block on stress response to tracheal intubation in the elderly

Objective To observe the effects of satellite ganglion block(SGB)on stress response to tracheal intubation in the elderly.Methods Forty-five patients aged≥65 years old were randomly divided into three groups with 15 cases eacK The patients in group LS received left SGB,those in group RS right SGB,and those in group C no SGB as the controls.SBP,DBP,MAP,HR wererecorded before anesthesia(T_0),after induction(T_1),at the time of trachealintubation(T_2),1 min(L_3)and 5 min(T_4)after trachealintubation.RPP was calculated.The venous samples were collectedfor the measurements of blood glucose(BG),cortisol(Cor)and adrenocorticotropin(ACTH)at T_0and T_4.Results BP and RPP were lower at T_1 than those at T_0 in 3 groups,which were higher at T_2than those at T_0 in group C as compared to those at T_0(P<0.05).HR and RPP of group LS wereincreased significantly(P<0.05),which of group RS were not.BG was increased significantly at T_4 ascompared to that at T_0 in group C(P<0.05),while Cor and ACTH were not changed remarkably inthe 3 groups.Conclusion Right SGB can effectively suppress the hemodynamic response to trachealintubation in the elderly.