全身麻醉复合双侧颈浅丛阻滞用于甲状腺手术的临床效果观察

目的研究全身麻醉复合双侧颈浅丛阻滞在甲状腺手术中的应用效果。方法择期行甲状腺手术患者80例,按随机数字表法分为全身麻醉复合双侧颈浅丛阻滞组（A组）和单纯全身麻醉组（B组）,每组40例,A组全身麻醉诱导后用1%利多卡因＋0.25%罗哌卡因进行双侧颈浅丛阻滞;B组进行常规全身麻醉;记录麻醉诱导前、诱导后、切皮时、手术开始后30 min、缝皮时的MAP和HR变化及两组患者复苏时恶心呕吐、躁动和疼痛的发生率。结果两组手术时间比较差异无统计学意义（P〉0.05）。B组切皮时、手术开始后30 min、缝皮时的MAP、HR均高于诱导前、诱导后及A组（P〈0.05）。两组复苏时恶心呕吐发生率比较,差异无统计学定义（P〉0.05）。B组复苏时躁动及疼痛发生率明显高于A组（P〈0.05）。结论全身麻醉复合双侧颈浅丛阻滞用于甲状腺手术可有效维持血流动力学稳定,减少苏醒期躁动及疼痛的发生。

Clinical effect observation of general anesthesia combined with bilateral superficial cervical plexus block applied in thyroid surgery

Objective To investigate application effect of general anesthesia combined with bilateral superficial cervical plexus block in thyroid surgery. Methods Eighty patients undergoing thyroid gland operation were divided randomly into general anesthesia general anesthesia combined with bilateral superficial cervical plexus block group（group A）and general anesthesia group（group B）,40 cases in each group.The general anesthesia with 1% lidocaine＋0.25% ropivacaine bilateral neck shallow plexus anesthesia were used in group A,and conventional general anesthesia was applied in group B.MAP and HR during recovery before and after anesthesia induction,at cutting skin,at 30 min after operation and the time of incision suture were recorded.The incidence rate of nausea and vomiting,restlessness and pain in two groups were recorded. Results Operation time of two groups was compared,with no statistical difference（P〈0.05）.MAP and HR at cutting skin,at 30 min after operation and the time of incision suture in group B was higher than that before and after anesthesia induction and group A respectively（P〉0.05）.The incidence rate of nausea and vomiting in two groups was compared,with no statistical difference（P〈0.05）.The incidence rate of restlessness and pain in group B was higher than that in group A respectively,with statistical difference（P〈0.05）. Conclusion General anesthesia combined with bilateral superficial cervical plexus block applied in thyroid surgery can effectively maintain hemodynamic stability,reduce the incidence of agitation and pain in anesthesia awakening period.