超声引导下下颌神经联合颈浅丛神经阻滞用于腮腺手术后镇痛的效果

Ultrasound guided mandibular nerve and cervical plexus nerve block for clinical evaluation of parotid gland operation for postoperative analgesia

目的探讨超声引导下下颌神经联合颈浅丛神经阻滞用于腮腺手术后镇痛的效果。方法选择腮腺手术患者60例,男29例,女31例,ASAⅠ或Ⅱ级,随机分为神经阻滞组和药物治疗组,每组30例。两组患者均采用全麻,药物治疗组根据术后需要,使用吗啡进行术后镇痛;神经阻滞组在手术结束后行超声引导下下颌神经合并颈浅丛神经阻滞。记录两组患者术后24h和48h吗啡使用量、运动以及静息VAS评分,以及术后同一时点吗啡使用比例。结果术后第1天神经阻滞组VAS评分均明显低于、吗啡使用量明显少于药物治疗组(P<0.05)。术后第2天,两组运动以及静息VAS评分差异无统计学意义。神经阻滞组术后同一时点吗啡使用比例明显小于药物治疗组。结论超声引导下下颌神经合并颈丛浅丛神经阻滞可以为腮腺手术提供术后镇痛,满足患者要求。

Objective To evaluate the effect of mandibular nerve and cervical plexus nerve block guided by ultrasound for postoperative analgesia of parotid gland operation.Methods Sixty patients of both sexes（29 males,31 females）,of ASA physical statusⅠ orⅡ with parotid gland operation,were randomly divided into two groups（n=30）：nerve block group and traditional drug group.All patients received general anaesthesia.In traditional drugs group,according to patient＇s request,we used analgesic drugs.In nerve block group,after general anaesthesia,we provided mandibular nerve and cervical plexus nerve block guided by ultrasound.Both groups were recorded the amount of analgesic drugs and rest/motor VAS after operation 1st day and 2nd day,the ratio of using analgesic drugs was also recorded at the same time.Results Compared with traditional drugs group,the amount of analgesic drugs and rest/motor VAS was decreased in nerve block group on the 1st day after operation.But on the 2nd day after operation,there was no difference between them.The ratio of using analgesic drugs of nerve block group was lower than that of traditional drug group.Conclusion Mandibular nerve and cervical plexus nerve block guided by ultrasound is effective for postoperative analgesia for parotid gland operation.