摘要
目的探讨食管引流型喉罩联合颈浅丛阻滞麻醉在甲状腺手术的临床应用。方法择期行甲状腺手术患者40例,ASAⅠ~Ⅱ级,随机分为研究组与对照组,每组20例。研究组采用食管引流型喉罩-颈浅丛阻滞联合麻醉,对照组单纯采用食管引流型喉罩,两组均以瑞芬太尼-异丙酚静脉泵注维持麻醉。结果研究组瑞芬太尼用量少于对照组（P〈0.01）,停麻药至拔喉罩时间短于对照组（P〈0.01）,术后疼痛分级也低于对照组（P〈0.01）。麻醉诱导后两组平均动脉压（MBP）与HR均较麻醉诱导前下降（P〈0.01）;插喉罩后两组MBP均回升至麻醉前水平（P〉0.05）,但HR仍低于麻醉前（P〈0.05）。拔喉罩后两组MBP及研究组HR均高于麻醉前（P〈0.05）;此时研究组HR高于对照组（P〈0.05）。结论食管引流型喉罩联合颈浅丛阻滞麻醉用于甲状腺手术,能减少瑞芬太尼用量、缩短停麻药至拔喉罩时间及提供较好术后镇痛,值得临床推广应用。
Objective To explore the feasibility and effect of general anesthesia via ProSeal laryngeal mask airway（PLMA） combined with superficial cervical plexus block（SCPB） anesthesia during thyroidectomy.Methods 40 patients undergoing elective thyroidectomy with ASA Ⅰ～Ⅱ were divided into study group and control group randomly,with 20 cases for each.PLMA-SCNB combined anesthesia was performed in study group and only PLMA anesthesia in control group.Remifentanil and propofol were pumped intravenously to achieve anesthesia maintenance.Remifentanil consumption,PLMA withdrawal time and postoperative pain scale（Ⅰ～Ⅳ） were recorded.MAP and HR were detected before anesthesia（T0）,after anesthesia induction（T1）,the time point after PLMA insertion（T2） and after PLMA extubation（T3）.Results Compared with control group,remifentanil dosage was less,PLMA withdrawal time was shorter and postoperative pain scale was lower in study group（P0.01）.Both MBP and HR were obviously decreased at the time point of T1 than those of T0 in both two groups（P0.01）.In both two groups,there was no statistical difference between MBP of T2 and MBP of T0（P0.05）,but HR of T2 was still lower than that of T0（P0.05）.MBP of T3 in both two groups and HR of T3 in study group were higher than those of T0（P0.05）.HR of T3 was higher in study group than that in control group（P0.05）. Conclusion The application of PLMA-SCPB combined anesthesia for thyroidectomy can reduce remifentanil consumption,shorten PLMA withdrawal time and offer ideal postoperative analgesia,and it is worth popularizing.
出处
《中国现代手术学杂志》
2010年第5期396-398,共3页
Chinese Journal of Modern Operative Surgery
关键词
全身麻醉
喉罩
颈丛
神经传导
甲状腺切除术
general anesthesia
laryngeal mask
cervical plexus
nerve block
thyroidectomy
