甲状腺手术颈丛麻醉应用地佐辛的临床分析

Clinical Analysis of Application of Dezocine in Cervical Plexus Anesthesia for Thyroidectomy

目的探讨地佐辛应用于甲状腺手术颈丛麻醉的临床情况。方法整群选取2012年1月—2013年12月在该院接受甲状腺手术的48例患者作为研究对象,将其随机分成观察组24例(颈丛神经阻滞联合地佐辛镇痛)和对照组24例(颈丛神经阻滞镇痛),观察并记录两组患者在麻醉手术前后Sp O2、HR、DBP、SBP的变化,以及患者的麻醉效果和不良反应情况;结果观察组与对照组相比,麻醉后在SBP、DBP、HR各项指标方相比差异有统计学意义(P<0.05),两组间在Sp O2方面相比差异均无统计学意义(P>0.05),麻醉后,观察组有1例(4.17%)患者出现镇痛不全情况,镇痛有效率及患者麻醉满意度均为95.83%,有3例(12.50%)患者出现不良反应,对照组有3例(12.50%)患者出现镇痛不全情况,镇痛有效率及患者麻醉满意度均为87.50%,对照组有18例(75%)患者出现不良反应,两组在镇痛效果、不良反应出现情况上相比差异有统计学意义(P<0.05)。结论地佐辛用于甲状腺手术止痛效果佳,能够控制颈丛麻醉下甲状腺手术时的心血管应激反应,是一种高效的麻醉辅助手段,适宜在临床上大力推行。

Objective To study the clinical application of dezocine in cervical plexus anesthesia for thyroidectomy. Methods 48 patients undergoing thyroidectomy in our hospital between January 2012 and December 2012 were selected as the research object and randomly divided into observation group with 24 patients who received cervical plexus nerve block combined with sheen anal-gesia） , and control group with 24 patients who received cervical plexus nerve block analgesia. The changes of SpO 2, HR, DBP, SBP, and the anesthetic effect, adverse reaction of the two groups before and after operation were observed and recorded. Results There were statistically significant differences between the indicators including SBP, DBP, HR of the two groups after anesthesia （P〈0.05）, and there was no statistically significant difference between SpO2 of the two groups （P〉0.05）; after anesthesia, both anesthetic effect rate and satisfaction with anesthesia of the observation group were 95.83% with 1 case （4.17%） of incomplete analgesia and 3 cases （12.50%） of adverse reaction;while both anesthetic effect rate and satisfaction with anesthesia of the control group were 87.50%with 3 case（12.50%） of incomplete analgesia and 18 cases （75%） of adverse reaction;in terms of anesthetic ef-fect and incidence of adverse reactions, there were statistically significant differences between the two groups （ P〈0.05）. Conclusion Dezocine in cervical plexus anesthesia for thyroidectomy can control cardiovascular stress reaction effectively, which is an effective support for anesthesia and suitable for promoting in clinic.