颈丛神经阻滞与静吸复合联合麻醉在甲状腺癌联合根治术中的应用

Clinical Application of Cervical Plexus Block Combined with Inhalation-Intravenous General Anesthesia in the Joint Radical Resection of Thyroid Carcinoma

【目的】研究颈丛神经阻滞与静吸复合联合麻醉方法在甲状腺癌联合根治术中应用的效果。【方法】选择 4 5例需行甲状腺癌联合根治术的患者 ,随机分为单纯静吸复合麻醉组 (A组 )和颈丛神经阻滞与静吸复合联合麻醉组 (B组 )。A组直接全麻 ,B组先颈丛神经阻滞再全麻 ,全麻诱导方法与维持方法两组相同。观察两组病人苏醒时间及气管导管拔除时间 ,记录术中芬太尼与维库溴铵的用药量及安氟醚的吸入浓度。【结果】B组与A组相比全麻药量明显减少并且苏醒时间及气管导管拔除时间明显缩短 (P <0 .0 5 )。另外 ,两组均无明显麻醉并发症。【结论】颈丛神经阻滞与静吸复合联合麻醉方法可有效地应用于甲状腺癌联合根治术中。

To study the therapeutic efficacy of cervical plexus block (CPB) combined inhalation-intravenous general anesthesia (IGA) for joint radical resection of thyroid carcinoma.Forty-five patients (ASA Ⅰ～Ⅱ) selected for joint radical resection of thyroid carcinoma were randomly divided into IGA group (Group A) and CPB combined with IGA group (Group B).IGA was arranged directly in Group A ; whereas in Group B, CPB was performed before IGA.In both groups, general anesthesia was induced with midazolam and fentanyl, and maintained with intermittent bolus of propofol, fentanyl, vencuronium and inhalation of enflurane. Vital signs, extubation time and wake-up time were observed, dosages of fentanyl and vencuronium as well as the inhaled concentration of enflurane during operation were recorded.The dosages of anesthetics administesia for general anesthetic in Group B reduced significantly; while its extubation time and wake-up time also obviously shortened as compared with those in Group A (P<0.05). In addition, there was no remarkable complication of anesthesia in both groups.[Conclusion]CPB combined with IGA can be applied safely and effectively in joint radical resection of thyroid carcinoma.