摘要
目的通过观察超声引导下头部周围神经阻滞对开颅手术患者血流动力学、应激反应的影响,探讨其临床价值。方法 60例颅内占位患者随机分为两组,对照组30例采取全身麻醉,观察组30例于全身麻醉前行超声引导下头部周围神经阻滞。比较两组术中不同时间点心率、平均动脉压水平,并测定血浆皮质醇、血管紧张素Ⅱ、血糖水平评估应激反应,统计两组术中麻醉药物丙泊酚、镇痛药物使用总量及不良反应发生情况。结果同组内与T0比较,T2、T3、T4时刻观察组MAP、HR水平差异无统计学意义(P>0.05),对照组MAP、HR水平升高(P<0.05);与观察组比较,对照组T2、T3、T4时刻MAP、HR水平升高(P<0.05)。同组内与T0比较,观察组T1、T2、T3、T4时刻皮质醇、血管紧张素Ⅱ水平均降低(均P<0.05);与对照组比较,观察组T2、T3、T4时刻皮质醇、血管紧张素Ⅱ、血糖水平均降低(均P<0.05)。两组手术时间比较差异无统计学意义(P>0.05);观察组丙泊酚及瑞芬太尼使用总量均低于对照组(均P<0.05);观察组术中不良反应发生率低于对照组(P<0.05)。结论超声引导下头部周围神经阻滞有助于维持开颅手术患者血流动力学稳定,并减轻应激反应,减少不良反应。
Objective To investigate the clinical value of ultrasound-guided peripheral nerve block on hemodynamics and stress response in patients undergoing craniotomy.Methods A total of 60 patients with intracranial space occupying were randomly divided into two groups,30 patients in the control group received general anesthesia,and 30 patients in the observation group received ultrasound-guided peripheral head nerve block before general anesthesia.The heart rate and average arterial pressure at different time points in the two groups were compared,and the plasma cortisol,angiotensinⅡand blood glucose levels were measured to assess the stress response.The total amount of anesthetic propofol and analgesic drugs used and the occurrence of adverse reactions in the two groups were calculated.Results Compared with T0 in the same group,there was no statistically significant difference in MAP and HR levels of the observation groups at T2,T3 and T4(P<0.05),and the levels of MAP and HR in the control group increased(P<0.05);Compared with the observation group,the levels of MAP and HR in the control group increased at T2,T3 and T4(P<0.05).In the observation group,cortisol and angiotensinⅡlevels were all reduced at T1,T2,T3 and T4 compared with those at T0(P<0.05);Compared with the control group,cortisol,angiotensinⅡand blood glucose levels in the observation group were all reduced at T2,T3 and T4(P<0.05).There was no significant difference in operation time between the two groups(P<0.05).The total amounts of propofol and remifentanil in the observation group were lower than those in the control group(P<0.05).The incidence of intraoperative adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion Ultrasound-guided peripheral nerve block is helpful to maintain hemodynamic stability in patients undergoing craniotomy,reduce stress response and adverse reactions.
作者
朱艺霞
王明虹
ZHU Yixia;WANG Minghong(Department of Anesthesiology,Ningde Hospital Affiliated to Fujian Medical University,Ningde,Fujian352100,Chin)
出处
《福建医药杂志》
CAS
2021年第2期18-21,F0004,共5页
Fujian Medical Journal
