超声引导下颈浅丛神经阻滞联合帕瑞昔布钠对全麻甲状腺手术患者术后镇痛及炎性反应的影响

Effect of Ultrasound-guided Superficial Cervical Plexus Nerve Block Combined with Parecoxib Sodium on Postoperative Analgesia and Inflammatory Response in Patients Undergoing Thyroid Surgery Under General Anesthesia

目的探讨超声引导下颈浅丛神经阻滞联合帕瑞昔布钠对全麻甲状腺手术患者术后镇痛、炎性反应的影响。方法选择扬州市江都人民医院2020年1—12月期间收治的60例甲状腺择期手术患者作为研究对象,按随机数表法分为对照组和观察组,各30例。对照组在麻醉诱导前进行超声引导下颈浅丛神经阻滞,观察组在颈浅丛神经阻滞成功后加用帕瑞昔布钠。记录并比较术后2 h(T1)、术后6 h(T2)、术后12 h(T3)、术后24 h(T4)、术后48 h(T5)疼痛评分,术前24 h(T0)、T4时点炎性反应指标,以及不良反应情况。结果T1~T4时,观察组VAS评分[(2.76±0.72)分、(2.33±0.47)分、(2.43±0.50)分、(1.56±0.50)分]均低于对照组,差异有统计学意义(t=-2.936、-8.847、-5.605、-2.497,P<0.05);但T5时两组VAS评分比较,差异无统计学意义(P>0.05)。T0时两组IL-6、CRP、TNF-α水平比较,差异无统计学意义(P>0.05);T4时观察组IL-6、CRP、TNF-α水平[(59.20±5.07)pg/mL、(16.56±3.09)mg/L、(30.70±3.89)pg/mL]均低于对照组,差异有统计学意义(t=-5.773、-5.202、-10.056,P<0.001)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论超声引导下颈浅丛神经阻滞联合帕瑞昔布钠可以巩固全麻甲状腺手术的术后疼痛,减轻炎性反应,安全性高。

Objective To investigate the effects of ultrasound-guided superficial cervical plexus nerve block combined with Parecoxib Sodium on postoperative analgesia and inflammatory response in patients undergoing thyroid surgery under general anesthesia.Methods Sixty patients admitted to Yangzhou Jiangdu People's Hospital for elective thyroid surgery from January to December 2020 were selected as the study subjects and divided into a control group and an observation group of 30 cases each according to the random number table method.In the control group,ultrasoundguided superficial cervical plexus nerve block was performed before induction of anesthesia,and after successful block of the superficial cervical plexus,the observation group was treated with Paroxycoxib Sodium.The pain scores at 2 h(T1),6 h(T2),12 h(T3),24 h(T4),and 48 h(T5)postoperatively,the inflammatory response indexes at 24 h(T0)and T4 preoperatively,and the adverse reactions were recorded and compared.Results At T1 to T4,the VAS scores of the observation group[(2.76±0.72)points,(2.33±0.47)points,(2.43±0.50)points,and(1.56±0.50)points]were lower than those of the control group,the difference was statistically significant(t=-2.936,-8.847,-5.605,-2.497,P<0.05);pared the level of IL-6,CRP,TNF-αat T0 between the two groups,the difference was not statistically significant(P>0.05).The levels of IL-6,CRP,TNF-αat T4,in the observation group(59.20±5.07)pg/mL,(16.56±3.09)mg/L,and(30.70±3.89)pg/mL were all lower than those in the control group,the difference was statistically significant(t=-5.773,-5.202,-10.056,P<0.001).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided superficial cervical plexus nerve block combined with Parecoxib Sodium can consolidate postoperative pain and reduce inflammatory response in general anesthesia thyroid surgery with high safety.