超声引导下颈丛神经阻滞联合全身麻醉在甲状腺术中的应用

Application of ultrasound-guided cervical plexus block combined with general anesthesia in thyroid surgery

目的分析甲状腺手术麻醉中应用全身麻醉联合颈丛神经阻滞的效果。方法选取梅州市人民医院2021年1—12月行甲状腺手术的75例患者,按随机数表法分组,对照组37例行全身麻醉,试验组38例行全身麻醉联合颈丛神经阻滞,比较两组围手术期指标、苏醒情况、疼痛程度及血流动力学。结果手术时间、补液量比较,两组差异无统计学意义(P>0.05);试验组患者的丙泊酚用量低于对照组,差异有统计学意义(P<0.05);视觉模拟评分法(VAS)评分比较试验组患者的术后4、8、12及24 h低于对照组,差异有统计学意义(P<0.05);试验组患者的吞咽时间、睁眼时间、应答时间短于对照组,差异有统计学意义(P<0.05);术毕舒张压(DBP)、心率(HR)、平均动脉压(MAP)及收缩压(SBP)水平比较试验组低于对照组,差异有统计学意义(P<0.05)。结论甲状腺手术中全身麻醉联合颈丛神经阻滞,可稳定血流动力学,有利于减轻疼痛,并缩短患者苏醒时间。

Objective To analyze the effect of general anesthesia combined with cervical plexus block in thyroid surgery anesthesia.Methods A total of 75 patients who underwent thyroid surgery at the People’s Hospital of Meizhou City from January to December 2021 were selected and randomly divided into two groups.The control group received 37 cases of general anesthesia and the experimental group received 38 cases of general anesthesia combined with cervical plexus block.The perioperative indicators,recovery status,pain level,and hemodynamics of the two groups were compared.Results There was no statistically significant difference in surgical time and fluid replacement between the two groups(P>0.05);The dosage of propofol in the experimental group was lower than that in the control group,with a statistically significant difference(P<0.05);The visual analogue scale(VAS)scores of patients in the experimental group were significantly lower than those in the control group at 4,8,12,and 24 hours after surgery(P<0.05);The swallowing time,eye opening time,and response time of the experimental group patients were shorter than those of the control group,with statistically significant differences(P<0.05);The levels of postoperative diastolic blood pressure(DBP),heart rate(HR),mean arterial pressure(MAP),and systolic blood pressure(SBP)in the experimental group were significantly lower than those in the control group(P<0.05).Conclusion General anesthesia combined with cervical plexus block during thyroid surgery can stabilize hemodynamics,alleviate pain,and shorten the patient's recovery time.