盐酸羟考酮注射液联合右美托咪啶在甲状腺手术颈丛神经阻滞麻醉中的应用

Application of oxycodone hydrochloride injection and dexmedetomidine undergoing the cervical plexus block for thyoidectomy

目的观察盐酸羟考酮注射液联合右美托咪啶辅助颈丛神经阻滞麻醉下行甲状腺手术的可行性及安全性。方法选择ASAⅠ~Ⅱ60例颈丛神经阻滞麻醉下甲状腺切除术患者,随机分为颈丛神经阻滞麻醉组(对照组)30例及颈丛神经阻滞麻醉下盐酸羟考酮注射液联合右美托咪啶组(观察组)30例。分别记录两组患者在入室时(T_0)、切皮即刻(T_1)、分离甲状腺肿物(T_2)、皮肤缝合时(T_3)等各时间点平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的变化。记录两组患者各时间点运动疼痛视觉模拟(VAS)评分、Ramsay镇静评分。观察围术期患者恶心、呕吐、呼吸抑制、窦性心动过缓等不良反应的发生情况。结果观察组在T_2、T_3时间点的MAP、HR均低于对照组(P<0.05)。T0时间点两组血流动力学指标差异无显著性(P>0.05)。两组颈丛神经阻滞麻醉VAS评分和Ramsay分级比较差异有显著性(P<0.05)。两组均未发生恶心、呕吐、呼吸抑制等不良反应。结论盐酸羟考酮注射液联合右美托咪啶可为颈丛神经阻滞麻醉下甲状腺切除手术提供满意的镇痛和镇静作用。

Objection To investigate oxycodone hydrochloride injection with dexmedetomidine auxiliary cervical plexus block anesthesia feasibility and safely of thyroid surgery.Mothod 60 cases of patients undergoing ASA grade Ⅰ-Ⅱ cervical plexus nerve block anesthesia in thyroid surgery were randomly divided in to two groups;30 cases in each group,cervical plexus nerve block anesthesia group,cervical plexus nerve block anesthesia with oxycodone hydrochloride injection and dexmedetomidine in group.Record the two groups of patients at room（T0）,cut skin instandy（T1） 、 separation of thyroid neoplasm（T2） 、 skin suture（T3） and so on each time point meant arterial pressure（MAP）,heart rate（HR）,the change of blood oxygen saturation（SpO2）.Record the paint of visual analogue scale（VAS）,Ramsay sedation scores with different time points in both groups.To observe the occurrence of adverse reation in perioperative patients,such as nausea,vomiting,respiratory depression,sinus bradycardia.Result The control group in T2、T3 point of MAP and HR were lower than observation group（P〈0.05）.Two groups of cervical plexus nerve block anesthesia VAS score and Ramsay grade differences are significal T（P〈0.05）.In two groups were note advers reactions such as nausea,vomiting inhibition.Conclusion Oxycdne hydrochloride injection in combination with dexmedetomidine privede satisfactory analgesia and comfort to cervical plexus nerve block anesthesia of thyroid surgery.