切口浸润罗哌卡因对全麻下甲状腺手术患者血流动力学的影响

The Effect of Skin Infiltration with 0.5% Ropivacaine on Hemodynamics during Thyroidectomy under General Anesthesia

目的：观察0．5％罗哌卡因局部切口浸润对患者在全麻下行甲状腺手术时的血流动力学的影响。方法：采用随机、双盲、对照设计，将40例甲状腺择期手术患者分为罗哌卡因组（A组）和生理盐水组（B组），每组各20例．全麻诱导后气管插管，持续吸入异氟醚维持麻醉直至手术结束．术中使用Bls监测麻醉深度，维持在50～60之间．切皮前10分钟分别用05％罗哌卡因10ml和09％生理盐水10ml进行切口局部皮下浸润，两组溶液均未加入肾上腺素。记录手术前、切口浸润即刻．切皮即刻及其后1分钟．2分钟、5分钟、缝合皮下组织、缝合皮肤时的平均动脉压（MAP）和心率（HR）。结果：罗哌卡因组切皮后1分钟，2分钟、5分钟、缝合皮下组织、缝合皮肤时的MAP、HR均低于生理盐水组（P〈0．05）。结论；0.5％罗哌卡因切口浸润麻醉．有效地预防了早状腺手术患者在全麻手术时切皮、缝合皮下组织、缝合皮肤时血压和心率的升高。

Objective： To observe the effect of skin infiltration with 0.5% ropivacaine on hemodynamics during thyroidectomy under general anesthesia. Methods： In this double-blind, randomized and placebo controlled study, 40 cases thyroid gland patients were divided into two groups. Twenty cases received skin infiltration with 0.5% ropivacaine 10 ml（ group A ）, others received 0.9, normal saline 10 ml （ group B ） before incision under general anesthesia. The mean arterial pressure （ MAP ）, heart rate （ HR ） were recorded preoperation, skin infiltration, skin cutting and 1,2,5 minutes after skin cutting skin suturation, operation termination. Results： The changes of MAP and HR in group A during 1,2,5 minutes after skin cutting and skin suturation were significantly less than those in group B（ P〈 0.05 ）.Conclusion： Skin infiltration with 0.5% ropivacaine could keep hemodynamics stable during thyroidectomy under general anesthesia.