术前枕大神经阻滞对甲状腺手术患者术后枕下痛的影响

Effect of Preoperative Greater Occipital Nerve Block on Suboccipital Pain after Thyroid Surgery

目的探讨术前枕大神经(greater occipital nerve,GON)阻滞对甲状腺次全切患者术后枕下痛的影响。方法选择80例ASAⅠ～Ⅱ级择期在全身麻醉下甲状腺次全切除术的甲状腺腺瘤患者,随机分为GON阻滞组(A组)和对照组(B组),每组40例。A组术前行GON阻滞,观察患者术后8h和24h枕部头痛、颈后疼痛情况,用VAS、VRS进行评估。结果术后12h和24hVAS评分A组明显低于B组(P<0.05)。术后12h和24hA组中重度疼痛患者明显少于B组(P<0.05)。结论术前GON阻滞是一种可以明显降低甲状腺手术患者术后枕下痛的方法。

Objective To study the effect of preoperative greater occipital nerve（GON） block on suboccipital pain after total thy-roidectomy. Methods Eighty ASA I - I1 patients with general anesthetic undergoing selective thyroid gland inferior total excision were randomly assigned to two groups（ n = 40） ：group A （GON block） , and group B （control group）. The intensity of pain was measured by using VAS and VRS, and recorded at 12 and 24 hour after operation. Results At postoperative 12 and 24 hours, VAS of occipital head- ache and posterior neck pain in group A was significantly lower compared to group B （ P 〈 0.05 ）. The proportion of patients reporting mod- erate or severe occipital and posterior neck pain at 12 and 24 hours postoperatively in group A was significantly less than that in group B（ P 〈 0.05）. Conclusion Preoperative GON block is an effective technique to reduce suboccipital pain after thyroid surgery.