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颈丛神经阻滞复合全麻用于颈椎手术的临床观察

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摘要 目的 采用颈丛神经阻滞复合全身麻醉,通过与单纯全身麻醉对比观察,了解其在经右侧颈椎前入路手术中血流动力学及麻醉效果的影响。方法选择ASAⅠ~Ⅱ级择期行经右侧颈椎前入路的手术患者40例,随机分为A、B2组。A组为经右侧颈丛神经阻滞加全麻组;B组为单纯全麻组。A组患者选用0.25%的盐酸左布比卡因18mL,行右侧颈深浅丛神经阻滞,效果确定后施行全麻。术中监测所有病人心电图(ECG)、收缩压(SBP)、舒张压(DBP)、心率(HR)、呼气末二氧化碳(PETCO2)和脉搏氧饱和度(SPO2),记录基础值(T0)、气管插管后(T1)、切皮(T2)、分离颈椎骨膜(T3)、术毕(T4)时SBP,DBP和HR。观察2组患者术中血流动力学的变化、全麻药用量及术后VAS疼痛评分。结果2组患者在手术开始切皮及分离骨膜时,A组的SBP、DBP、HR均明显低于B组,A组术中血流动力学较B组稳定,全麻药用量较B组减少,术后1hVAS疼痛评分优于B组。 Objective To use cervical plexus nerve block to compound general anesthesia.The effects of hemodynamics and anaesthesia in the operation of the right cervical spine were studied by comparison with general anesthesia.Methods Choose ASAⅠ~Ⅱlevel40patients undergoing elective surgery patients that needs to be operated on the right anterior cervical vertebrae.Randomly divided into groups A and B:Group A was the right cervical plexus nerve block combined with general anesthesia.Group B was only general anesthesia group.The patients of group A were selected for the right neck deep and superficial cervical plexus nerve.Patients were treated with0.25%left bupivacaine hydrochloride18mL.General anesthesia was performed after the effect was satisfaction.All patients were monitored for ECG、SBP、DBP、HR、PETCO2and SPO2.Record the following data separately:the SBP、DBP and HR were recorded based on the basal values(T0),the endotracheal intubation(T1),the surgical cutting(T2),the separation of the cervical periosteum(T3)and the end of the operation(T4).The changes of hemodynamic,total anesthetic dosage and postoperative VAS pain score observed in two groups of patients.Results The SBP,DBP and HR of group A were significantly lower than group B when the groups of patients began to cutting and separating the cervical periosteum during the operation.The dosage of general anesthetic drugs was significantly reduced compared with group B,and postoperative1h VAS pain score was better than group B.
机构地区 贵州医科大学
出处 《世界中医药》 CAS 2017年第A02期367-367,370,共2页 World Chinese Medicine
关键词 颈丛神经阻滞 全麻 颈椎手术 Cervical plexus nerve block General anesthesia Cervical spine surgery
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