摘要
目的观察星状神经节阻滞(SGB)对老年高血压患者气管插管心血管不良反应的影响。方法老年高血压手术患者40例随机均分为两组:全身麻醉诱导前,SGB组在超声引导下行左侧SGB,C组不做SGB作为对照。记录麻醉诱导前(T1)、气管插管前(T2)、插管后即刻(T3)、1min(T4)和3min(T5)时的MAP、HR和SpO_2。同时采用ELISA法测定血浆肾上腺素(E)和去甲肾上腺素(NE)浓度。结果 T3时,SGB组的HR和MAP均低于C组(P<0.01)。SGB组T2～T5时的血浆E浓度低于C组(P<0.05),T2、T3时的血浆NE浓度低于C组(P<0.05)。SGB组患者均成功完成SGB,无局部血肿或感染病例;6例患者观察到阻滞后出现声音撕哑,术毕即自行消失。结论全身麻醉诱导前行超声引导下左侧SGB可以减少E和NE的分泌,降低气管插管反应,有效稳定老年高血压患者气管插管期的HR和MAP。
Objective To observe the effect of ultrasound-guided stellate ganglion block (SGB) on the cardiovascular adverse responses to endotracheal intubation in elderly patients with hypertension.Methods Forty elderly patients with hypertension undergoing selective surgery under general anesthesia were randomly divided into two groups with 20 cases each.The left SGB under the guidance of ultrasound was performed before anesthesia induction in group SGB,which was not in group C as the control.The HR,MAP and SpO2were recorded before anesthesia induction (T1), before endotracheal intubation (T2),immediately after endotracheal intubation (T3),at 1 minute (T4)and 3 minutes after endotracheal intubation(T5).The plasma concentrations of epinephrine (E) and norepinephrine (NE)were detected by ELISA method.Results The HR and MAP at T3 were lower in group SGB than those in group C (P<0.01).The plasma concentration of E at T2-T5was lower in group SGB than that in group C (P<0.05)and that of NE at T2 and T3 was lower in group SGB than that in group C (P<0.05).The SGB was successful in all 20 cases of group SGB without any case with local hematoma or infection.There were 6 cases with horse voice,which disappeared after operation without special treatment.Conclusion The left SGB under the guidance of ultrasound before anesthesia induction may reduce the secretion of E and NE,attenuate the cardiovascular adverse responses to endotracheal intubation and keep circulation stable during the induction of general anesthesia in elderly patients with hypertension.
作者
缪建中
顾正峰
陈建庆
MIAO Jianzhong;GU Zhengfeng;CHEN Jianqing(Department of Anesthesioloy ,Affiliated Jiangyin Hospital,Southeast University Medical College,Jiangyin 214400,CHINA)
出处
《江苏医药》
CAS
2018年第11期1297-1299,共3页
Jiangsu Medical Journal
