摘要
目的 探讨星状神经节阻滞（SGB）对甲状腺手术患者颈丛阻滞时心率变异性的影响.方法 择期行甲状腺腺瘤切除术的患者45例,ASA Ⅰ或Ⅱ级,年龄20～60岁,体重40～70 kg,性别不限,随机分为3组（n=15）：对照组（C组）、左侧SCB组（LS组）及右侧SGB组（RS组）.SGB成功后15 min行颈丛神经阻滞.于入室后（基础状态）、颈丛阻滞结束即刻、阻滞5min.10min、切皮及术毕时记录SBP、DBP、HR;心率变异性参数：总功率（TP）、低频功率（LF）、高频功率（HF）、低频与高频比值（IF/HF比值）,并计算LF、HF的标准化值（LFnu、HFnu）.结果 与基础值相比,术中C组LFnu和LF/HF比值升高,HR、HF及HFnu下降,RS组LF、HF及HFnu下降,HR升高,三组SBP和DBP均升高（P〈0.05或0.01）,LS组心率变异性参数差异无统计学意义（P〉0.05）.与C组相比,LS组HR、LFnu下降,HF和HFnu升高（P〈0.05）,RS组上述指标差异无统计学意义（P〉0.05）.结论 甲状腺手术患者颈丛阻滞前行SGB可调节颈丛阻滞引起的交感神经兴奋性,维持交感/副交感神经张力平衡,且左侧SGB效果较好.
Objective To investigate the effect of stellate ganglion block（SGB）on heart mte variability （HRV）during thyroidectomy performed under cervical plexus block.Methods Forty-five ASA Ⅰ or Ⅱ pafients of both sexy8（8 males,37 females） aged 20-60 yr,weighing 40-70 kg undergoing elective thyroidectomy under cervical plexus block were randomly divided into 3 groups（n=15 each）：group Ⅰ control,group Ⅱ left SGB and group Ⅲ right SGB.The parameters of HRV included low frequency（LF）,high frequency（HF）,LFnu,HFnu and LF/HF ratio.SBP,DBP,HB and HRV parameters were recorded before anesthesia（To,baseline）,immediately（T1） and at 5 and 10 rain after cervical plexus block（T2,T3）,at the beginning and end of operation （T4,T5）.Results SBP and DBP were significantly increased at different time points after cervical plexus block in all 3 groups.Compared with the baseline at T0,LFnu and LF/HF ratio were significantly increased while HR,HF and HFnu decreased during operation in group Ⅰ,LF,HF and HFnu were significantly decreased while HR increased during operation in group Ⅲ（P〈0.05）,but no significant change in HRV parameters was found during operation in group Ⅱ（P〉0.05）.Compared with group Ⅰ,HR and LFnu were significantly decreased while HF and HFnu increased in group Ⅱ（P〈0.05）,but no significant change was found in the indexes mentioned abovein group Ⅲ （P〉0.05）.Conclusion SGB can adjust cervical plexus block-induced sympathetic excitability and maintain the balance between sympathetic and parasympathetic tension.Left SGB outweighs right SGB.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2010年第4期409-412,共4页
Chinese Journal of Anesthesiology
关键词
星状神经节
颈丛
神经传导阻滞
心率
Stellate ganglion
Cervical plexus
Nerve block
Heart rate
