全麻复合颈丛阻滞对甲状腺手术患者甲状腺功能和应激反应的影响

Effects of general anesthesia combined with cervical plexal block on thyroid function and stress response in patients undergoing thyroidectomy

目的：研究全麻复合颈丛阻滞对甲状腺手术患者甲状腺功能和对患者应激反应的影响。方法：选择美国麻醉医师协会（ASA）I-Ⅱ级择期行甲状腺肿物切除手术的患者40例，随机分成2组，每组各20例。麻醉维持分别采用单纯丙泊酚全凭静脉麻醉组（A组）和丙泊酚全凭静脉麻醉组复合颈丛阻滞组（B组）。麻醉中监测2组患者的血压和心率，并分别于麻醉诱导前（T1）、气管插管前1min（T2）、气管插管后1min（T3）、切皮后1min（T4）、手术探查（T5）、手术结束（T6）采血测定血浆血浆TSH、T3、T4浓度和皮质醇（Cor）水平。结果：B组的血压的稳定性优于A组，B组的应激反应较A组轻。结论：全麻复合颈丛阻滞能减少甲状腺手术患者腹腔镜胆囊切除术患者机体应激反应。

Objective To investigate the effects of general anesthesia combined with cervical plexal block on thyroid function and stress response in patients undergoing thyroidectomy. Methods Forty patients with ASA I- II grade receiving thyroidectomy were randomly divided into 2 groups （each n = 20）. All patients received propofol intravenous anesthesia （Group A） or propofol intravenous anesthesia combined with cervical plexal block （Group B）. Blood pressure and heart rate of all patients were observed; and serum levels of TSH, T3, ＂1＂4 and cortisol （Cor） before anesthesia （T1）, 1 rain before intubation （T2）, 1 min after intubation （T3）, 1 min after skin incision （T4）, during surgical exploration （Ts） and at the end of surgery （T6） in all patients were measured. Results In Group B, the blood pressure was more stable and the stress response was milder than those in Group A, respectively. Conclusion General anesthesia combined with cervical plexal block could reduce the stress response in patients undergoing thyroidectomy