摘要
目的评价超声引导喉上神经阻滞(superior laryngel nerve block,SLNB)联合颈神经通路阻滞(cervical nerves pathway block,CNPB)对甲状腺癌手术喉返神经监测的影响。方法甲状腺癌患者90例,采用随机数字表法分为2组,神经阻滞组(A组)和对照组(B组)。A组患者术前行超声引导喉上神经联合颈神经通路阻滞。观察A组患者神经阻滞前后声音、膈肌运动情况和SpO2数值,患者插管条件评分和手术相关内容。记录25%TOFR恢复时间(T1)、75%TOFR恢复时间(T2)、90%TOFR恢复时间(T3)、术者初次探查迷走神经时间(T4)和探查喉返神经时间(T5)及各时间点神经监测肌电信号波幅峰值。观察患者术后2、12、24和48 h患者VAS评分,术后恶心呕吐和咽喉疼痛等不良反应。结果与A组相比,B组患者插管条件达到优等级例数明显减少,丙泊酚和瑞芬太尼用量增多,术中呛咳例数和术后咽喉疼痛例数增多,24 h内VAS评分增高。结论神经阻滞提高了患者插管条件,减少了术中丙泊酚和瑞芬太尼用量,降低了术中呛咳患者例数,减轻了患者术后咽喉疼痛和24 h内患者疼痛评分。
Objective To evaluate the effects of ultrasound-guided superior laryngeal nerve block(SLNB combined cervical nerves pathway block(CNPB)on the monitoring of recurrent laryngeal nerve in thyroid cancer surgery.Methods A total of 90 patients with thyroid cancer surgery were divided into two groups by random number table method.Group A is nerve block and group B is observation control group.Patients in group A were given SLNB and CNPB before surgery.Sound condition,diaphragm movement and SpO2 in group A were observed before and after nerve block.Patients intubation condition score and surgical related content.T1-T5 time and each time point peak amplitude of neuromuscular signal were observed.VAS scores of the patients at 2,12,24 and 48 h after surgery,as well as postoperative nausea,vomiting and throat pain and other adverse reactions were observed.Results Compared with group A,the number of patients in group B with superior intubation conditions was significantly lower.The dosages of propofol and remifentanil were increased.The numbers of patients with intraoperative cough and postoperative throat pain was increased.The VAS score was increased within 24 h.Conclusion Nerve block improved the intubation conditions of patients,reduced the intraoperative dosages of propofol and remifentanil.Nerve block reduced the number of patients with cough during the operation,the postoperative throat pain and VAS score of patients within 24 hours.
作者
冯爱敏
何双双
卢锡华
乔迎帅
FENG Aimin;HE Shuangshuang;LU Xihua;QIAO Yingshuai(Department of Anesthesiology,Henan Tumor Hospital,Zhengzhou 450000,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第16期2598-2602,共5页
The Journal of Practical Medicine
基金
河南省科技计划项目(编号：162102310316)
关键词
神经阻滞
甲状腺肿瘤
罗哌卡因
喉神经
plexus block
thyroid neoplasms
ropivacaine
laryngeal nerves
