摘要
目的研究双侧颈浅丛阻滞复合全身麻醉对甲状腺手术围手术期镇痛药物用量及其术后恶心呕吐率的影响。方法选择50例拟行甲状腺手术的患者,随机分为全麻组(A组)和全麻复合双侧颈浅丛阻滞组(B组),每组25例。A组进行常规全身麻醉,B组全麻诱导后用0.75%布比卡因进行双侧颈浅丛神经阻滞。记录术中雷米芬太尼的使用总量,采用VAS评分对术后0 h、4 h、8 h、12 h、16 h、20 h及24 h疼痛评分,并记录术后首次使用镇痛药物的时间及例数,并记录术后恶心呕吐率。结果两组术中输注雷米芬太尼的总量差异有统计学意义(p<0.01),B组患者术后即刻、术后4 h、8 h的VAS评分均低于A组(p<0.05),术后12 h、16 h、20 h和24 h的VAS评分两组间的差异无统计学意义(均p>0.05),A组术后24 h需要镇痛药物的比例是64%(16/25),B组术后24 h需要镇痛药物的比例是16%(4/25),组间差异有统计学意义(p<0.01)。术后恶心呕吐的发生率A组为48%(12/25),B组为12%(3/25),组间差异有统计学意义(p<0.05)。结论全麻复合双侧颈浅丛神经阻滞可有效降低术中及术后镇痛药物的用量,有效地降低了术后恶心呕吐的发生率。
Objective To investigate the analgesic efficacy and postoperative nausea and vomiting of bilateral superficial cervical plexus block combined with general anesthesia in patients undergoing thyroidectomy.Methods 50 patients who underwent thyriodectomy were randomly assigned into control group（group A,n=25） or bilateral cervical plexus block group（group B,n=25）.In group A,the patients underwent general anesthesia.In group B,bilateral superficial cervical plexus block was performed after anesthesia induction.The number of patients asking for analgesics,the time to the first analgesics required,VAS scores and postoperative nausea and vomiting for 24 h were assessed.Results Total intraoperative infusion dosage of remifentanil was significantly higher in group A than in group B.The VAS scores were lower at 0 h,4 h,8 h in group B than in group A（p0.05）.The number of patients requiring analgesics during 24 h after operation was significantly higher in group A than in group B（16/25 Vs.4/25）（p0.05）.Incidents of postoperative nausea and vomiting was significantly higher in group A than in group B（12/25 V.S.3/25）（p0.05）.Conclusion Bilateral superficial cervical plexus block combined with general anesthesia reduces perioperative anesthetics usage,which results in lower posteroperative nausea and vomiting.
出处
《现代医院》
2011年第5期27-29,共3页
Modern Hospitals
关键词
甲状腺
麻醉
颈丛阻滞
疼痛
恶心呕吐
Thyroidectomy
Cervical plexus block
General anesthesia
PONV
