不同浓度局麻药行颈丛阻滞对通气功能的影响

Effect of Cervical Plexus Block with Local Anesthetics of Different Concentration on Ventilatory Function

目的：观察不同浓度局麻药行颈丛阻滞对通气功能的影响。方法：选择４０例按美国麻醉医师协会评级标准（ＡＳＡ）为Ⅰ级择期甲状腺手术病人，随机分Ａ、Ｂ两组，Ａ组用２０％利多卡因、０．５％布比卡因，１：２０万肾上腺素混合液；Ｂ组用１％利多卡因，０．２５％布比卡因，１：２０万肾上腺素混合液。分别在阻滞前、阻滞后１５ｍｉｎ、用杜－氟合剂１ｕ后分别５ｍｉｎ分别记录潮气量（ＶＴ）、肺活量（ＶＣ）、呼吸频率（Ｒ），脉搏血氧饱和度（ＳＰＯ２）。结果：Ａ组：阻滞１５ｍｉｎ后，ＶＣ显著下降，Ｒ显著增状，ＶＴ、ＳＰＯ２变化不明显，用合剂后，ＶＴ、ＳＰＯ２显著下降；Ｂ组：相对应的ＶＴ、ＶＣ、ＳＰＯ２均显著下降，但与Ａ组相比，其下降幅度较小，具有显著性差异。结论：双侧颈丛阻滞均存在不同程度的膈肌麻痹。

Objective:To evaluate the effect of cervical plexus block with local anesthetics at different concentrations on the ventilatory function.Methods:40 ASA-I patients for thyroid procedures were randomly divided into two groups, in which the use of lidocaine and bupivavaine was 20%, 0.5%(Group I), and 1%, 0.25%(Group II) respectively, with a same dosage of adrenaline (1/200,000). The tidal volume (VT), vital capacity (VC), respiratory rate (R) and pulse oxygen saturation of blood SPO2 were recorded before block, at 15 minutes after block and 5 minutes after the administration of K1 Dolantine(50 mg) and Droperidol(5mg)(D-Diu).Results:Compared with Group I, the VT, VC and SPO2 were significantly decreased in Group II, which suggested a marked difference between the two groups.Conclusion: The phrenoparalysis due to cervical plexus block can be suppressed by the use of local anesthetics at a lower concentration.