治疗剂量高乌甲素加入颈丛阻滞液中对心血管的影响

The cardiacvascular effect of treating dosage lappaconitine added into the cervial plexum blocking drug

目的观察治疗剂量高乌甲素加入颈丛神经阻滞局麻液中对血压、心率的影响。方法选择60例甲状腺肿瘤切除术患者,随机分为3组,采用一针法C4双侧颈浅和病侧颈深丛阻滞。3组颈丛阻滞药液均为1%利多卡因加0.25%罗派卡因混合液,总量30ml。L组(高乌甲素组)在颈丛阻滞液中加入高乌甲素8mg;F(芬太尼组)组在颈丛阻滞液中加入芬太尼0.1mg;C组(对照组)颈丛阻滞液中不加其它药物。观察患者入室时、阻滞后5、10、15min、肿瘤摘除即刻和手术结束时的收缩压(SBP)、舒张压(DBP)、心率(HR)。结果L组:HR在颈丛阻滞后5min和SBP、DBP、HR在颈丛阻滞后10、15min及DBP、HR在肿瘤摘除时较阻滞前有明显升高(P<0.05和P<0.01)。F组:SBP、DBP、HR在颈丛阻滞后5、10、15min和HR在肿瘤摘除时较阻滞前有明显升高(P<0.05和P<0.01)。C组:SBP、DBP、HR在阻滞后各时间点均较阻滞前有明显升高(P<0.05和P<0.01)。组间比较:L组SBP在肿瘤摘除即刻、手术结束时和DBP、HR在手术结束时比对照组有明显的下降(P<0.05);F组SBP、DBP、HR在手术结束时比对照组有明显的下降(P<0.05)。结论治疗剂量高乌甲素加入颈丛阻滞液中能一定程度的降低心血管副作用,与芬太尼效果相同,值得推广。

Objective To observe the treating dosage lappaconitine＇effect on the blood pressure and heart rate.Methods 60 thyroidectomy patients were divided into three groups.One stitch blocking block the bilateral superficial cervical nerve block and disease-side deep cervical nerve block.cervial plexum blocking drugs of three groups were all 30 ml 1% lidocaine added with 0.25% ropivacaine.lappaconitine was added into the cervical plexum blocking drug in L group（lappaconitine）;Fentanyl 0.1㎎was added into the cervical plexum blocking drug in the F（fentanyl） group; There was not added drug in the C group （control）.The patients＇SBP,DBP,HR were observed at the times of patient entering into the operation room,5,10,15min after blocking ,and tumor excision and operation completion.Results L group：HR at the time of 5min after blocking. SBP,DBP,HR at the time of 10,15min after blocking,DBP,HR at the time of tumor excision increased significantly than those of pre-blocking （P〈0.05 and P〈0.01）.F group：SBP,DBP,HR at the time of 5,10,15min after blocking and HR at the time of tumor excision increased significantly than those of pre-blocking（P〈0.05 and P〈0.01）.C group：SBP,DBP,HR at all times increased significantly than those of pre-blocking（P〈0.05 and P〈0.01）.Between group comparison：SBP at the time of tumor excision and operation completion ,DBP,HR at the time of operation completion in L group decreased significantly than those of C group （P〈0.05）.SBP,DBP,HR at the time of operation completion in F group decreased significantly than those of C group （P〈0.05）.Conclusion Treating dosage lappaconitine added into the cervial plexum blocking drug is a valuable method due to it can decrease the cardiacvascular reaction in some degree as well as fentanyl.