瑞芬太尼辅助颈丛神经阻滞用于甲状腺手术的临床观察

Remifentanil-Assisted Cervical Plexus Nerve Block for the Clinical Observation of Thyroidectomy

目的：探讨瑞芬太尼辅助颈丛神经阻滞用于甲状腺手术的可行性。方法：ASAⅠ-Ⅱ级甲状腺次切除术的患者60例,随机分为瑞芬组（R组,n=30）和芬太尼组（F组,n=30）。R组先静脉注射瑞芬太尼0.05mg,继以0.1-0.12μg.kg-1.min-1持续泵入;F组给予芬太尼氟哌利多混合液2ml,观察10min后两组均行C4一针法双侧颈丛阻滞。结果：手术时血压、心率明显高于手术前（P〈0.05）,F组明显高于R组（P〈0.05）;两组在吸氧状态下脉氧均无明显降低,R组有2例患者在给瑞芬首剂后出现呼吸暂停。OAA/S评分两组差异有统计学意义（P〈0.05）。患者术中合作度评级：R组明显优于F组（P〈0.05）。结论：瑞芬太尼可安全有效辅助颈丛神经阻滞用于甲状腺手术。

Objective：To investigate the remifentanil-assisted cervical plexus nerve block for the feasibility of thyroid surgery.Methods：ASA ⅠⅡ level of thyroid surgery patients 60 cases,were randomly divided into remifendell group（R group,n=30）and Fentanyl group（F group,n=30）.R group to intravenous remifentanil 0.05mg,followed by 0.1 0.12μg·kg-1·min-1 continued pump.F group given 2ml fentanyl droperidol mixture.After 10minutes observation in both groups,a line C4 acupuncture carotid plexus block was used.Results：During the surgical operation,blood pressure,heart rate were significantly higher than that before surgery（P〈0.05）,F group was significantly higher than the R group（P〈0.05）.The level of sPO2 in two groups have no significant decrease in a state of oxygen.Breathing holding was found in 2 patients after the first dose remifendell.OAA/S score of R group has significantly difference compared to that of F group（P〈0.05）.Degree of co-operation patients rating：R group was significantly higher than F group（P〈0.05）.Conclusion：Remifentanil maybe safely and effectively assist cervical plexus nerve block for thyroid surgery.