超声引导颈丛阻滞联合羟考酮全麻镇痛在颈椎手术中的应用

Application of ultrasound-guided cervical plexus block combined with oxycodone general anesthesia analgesia in cervical spine surgery

目的研究超声引导下颈丛阻滞联合盐酸羟考酮注射液全麻镇痛在颈椎前路手术的应用效果。方法选择择期行颈椎间盘切除植骨融合术和钢板内固定术病例30例。随机分为超声引导颈丛神经阻滞全麻组(N组)和超声引导下颈丛神经阻滞联合羟考酮组(S组),每组15例。分别记录两组患者在手术插管即刻、椎管减压时、安装内固定、皮肤缝合各时间点平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO_(2))的变化。记录两组患者苏醒期躁动(EA),观察围术期患者恶心、呕吐等不良反应的发生情况。结果两组患者MAP、HR、SPO_(2)动态生命体征指标差异无统计学意义;S组患者EA及不良反应发生率少于N组患者,差异有统计学意义(P<0.05)。结论超声引导下颈丛阻滞联合羟考酮全麻生理干扰小,术后镇痛时间长,镇痛效果好。

Objective To study the effect of combined cervical plexus block combined with oxycodone hydrochloride injection in general anesthesia analgesia in anterior cervical surgery.Methods Thirty cases were selected for cervical disc resection,bone grafting and fusion and plate internal fixation.The patients were randomly divided into two groups:the general anesthesia group(N group)and the group of ultrasonic guided cervical plexus block combined with oxycodone(S group),each group 15 cases.The changes of mean arterial pressure(MAP),heart rate(HR),and SpO_(2) were recorded in the two groups at the time of intubation,decompression of vertebral canal,internal fixation,skin suture.The patients in the two groups were recorded for restlessness(EA)during the wake up period,and the adverse reactions of nausea,vomiting and other adverse reactions were observed.Results There was no significant difference in MAP,HR and SpO_(2) dynamic vital signs between the two groups,and the incidence of EA and adverse reactions in group S patients was lower than that of group N(P<0.05).Conclusion Ultrasound guided cervical plexus block combined with oxycodone general anesthesia has little physiological interference,long postoperative analgesia time and good analgesic effect.