水针麻醉和颈丛麻醉用于甲状腺手术比较

目的 观察水针麻醉和颈丛麻醉用于甲状腺手术的麻醉效果及不良反应的发生率.方法 82例普外科择期甲状腺手术患者,随机分为两组,每组41例,A组水针麻醉,B组颈丛麻醉.对患者一般情况如切皮,分肌肉,摘除病灶,缝肌肉,缝皮肤的表现和疼痛情况进行观察,并对患者上述时间段呼吸,血压,脉搏,血氧饱和度进行统计学观察.结果 两组患者年龄,体重,手术时间比较差异无统计学意义(P＜0.05).A组穴位针刺起效时间与B组神经阻滞起效时间无明显差异 (P＞0.05),A组感觉恢复时间明显长于B组(P＜0.05),两组麻醉前血压、脉搏于麻醉后血压、脉搏相比较无明显差异(P＞0.05),B组不良反应如局麻药中毒反应,喉返神经阻滞,Horner综合症,膈神经麻痹,椎动脉损伤等的发生率明显高于A组(P＜0.05).水针麻醉重复用药容易而颈从麻醉术中无法追加、重复用药困难.结论 水针麻醉应用于甲状腺手术优于颈丛麻醉,且不良反应颈丛麻醉明显高于水针麻醉.

Comparison of the Application of Fluid Acupuncture Anesthesia and Cervical Plexus Anesthesia in Thyroid Surgeries

Objective Observe the anesthesia effects and incidence of adverse reactions of the application of fluid acupuncture anesthesia and cervical plexus anesthesia in thyroid surgeries. Methods Eighty two cases of patients with thyroid surgery from general surgery department are divided into two groups randomly. Each group with 41 cases, group A is fluid acupuncture anesthesia and group B is cervical plexus anesthesia. Observe the general conditions of the patients, like their reactions and pain situations towards skin incision, muscle dividing, focus removing, muscle suturing, skin suturing and also conduct a statistics observation of the breathe, blood pressure, pulse and oxyhemoglobin saturation of the patients during the above mentioned period. Results The comparison of the age, weight and surgery time of the two groups has no statistic meaning （P〈0.05） . The onset time of group A＇s point acupuncture has no distinct difference with group B＇s nerve block （P〉0.05） . The feeling recovery time of group A is apparently longer than group B （P〈0.05） . The blood pressure and pulse before anesthesia of the two groups have no obvious difference comparing with which after anesthesia （P~0.05） . The adverse reactions of group B are toxic reaction of local anesthetic, recurrent laryngeal nerve block, Homer syndrome, phrenic nerve paralysis and the damages of vertebral artery, the incidence of which is apparently higher than group A （P〈0.05） . Repeated drug use is much easier in fluid acupuncture anesthesia, while the repeated drug use is very difficult in cervical plexus anesthesia cause the drugs cannot be added during surgery. Conclusion The application of fluid acupuncture anesthesia in thyroid surgeries is better than cervical plexus anesthesia and the adverse reactions of cervical plexus anesthesia are clearly higher than fluid acupuncture anesthesia.