星状神经节阻滞在侧脑室腹腔分流术中的应用

An Application of Stellate Ganglionic Block in Operation of Ventricle peritoneal by pass Flow

将择期侧脑室腹腔分流术病人３２例随机等分成星状神经节阻滞（ＳＧＢ，Ｓ）和非ＳＧＢ（Ｎ）２组。术前均肌注鲁米那、阿托品；Ｓ组以０．８８％利多卡因于手术侧行ＳＧＢ。２组均用局麻＋杜冷丁＋氟哌啶麻醉，术中刺激大时酌情加用氯胺酮。监测病人入室（Ｔ０）到手术开始（Ｔ４）、皮下造瘘（Ｔ５）等各期的收缩压（ＳＰ）、舒张压（ＤＰ）和入室心率（ＨＲ）等，并记录静脉用药量和次数。结果：Ｓ组Ｔ４和Ｔ５时的ＳＰ、ＨＲ均低于Ｎ组（Ｐ＜０．０５和Ｐ＜０．０１）；杜冷丁、氟哌啶和氯胺酮的用量和次数Ｓ组均少于Ｎ组（Ｐ＜０．０５和Ｐ＜０．０１）。提示：ＳＧＢ在手术中有加强镇痛。

hirty two cases of patients for the surgery were selected: Luminal and atropine were admi nistrated (i.m) before operation.Patients were randomly divided into 2 groups, SGB(S) and non SGB(N). A solution of 0.88% lidocain was ipsilaterrally injected in group S and its effectiveness was determined by pupil constriction. Both local and pethidine plus droperidol anesthesia were applied in the two groups and ketamine was added when stimulation was stronger during the surgery. Systolic(SP), distolic(DP) and HR were simultaneously monitored at time of entry(T 0),beginning operation (T 4), and subcutaneous fistulation(T 5). Dosage and number of intravenous administration were also recorded. Both SP and HR at T 4 and T 5 were S<N( P <0.05 and 0.01, respectively). Dosage of both pethidime and ketamine was S<N( P <0.05 and 0.01, respectively). These results indicate that the treatment of SGB may exert its role in improving analgesia and stabilization of circulation during surgery and its usage is recommended for sympathetic dominant patients during their operation.