甲状腺瘤手术中颈丛神经阻滞联合瑞芬太尼丙泊酚麻醉效果评价

Evaluation of the anesthetic effect of cervical plexus block combined with remifentanil and propofol in thyroid surgery

目的探讨甲状腺瘤手术中实施颈丛神经阻滞联合瑞芬太尼丙泊酚麻醉的临床价值。方法于2020年6月—2022年6月阶段采集病例展开研究,实施对象为60例甲状腺瘤手术患者,经严格纳排后基于随机数字表法合理分组,组别对照组(应用颈丛神经阻滞麻醉)30例与观察组(应用颈丛神经阻滞联合瑞芬太尼丙泊酚麻醉)30例;检测不同时间点的血流动力学指标变化,统计不良反应发生率,以上数据两组对比。结果不同时间点两组患者血氧饱和度变化均不大(P>0.05),颈丛阻滞后-皮肤缝合时观察组心率、平均动脉压变化较对照组更小,血流动力学更稳定(P<0.05);观察组肢体活动发生率明显低于对照组(P<0.05),两组肌肉僵直、呼吸抑制、恶心不适发生率比较(P>0.05)。结论颈丛神经阻滞联合瑞芬太尼丙泊酚麻醉用于甲状腺瘤手术中,有利于患者血流动力学指标维持稳定,确保麻醉安全且可控,确保手术顺利开展,具有应用推广的价值。

Objective To explore the clinical value of cervical plexus block combined with remifentanil and propofol anesthesia in thyroid tumor surgery.Methods From June 2020 to June 2022,the cases were collected and studied.The subjects were 60 patients with thyroid tumor undergoing operation.After strict admission,they were randomly divided into control group(30 cases were treated with cervical plexus block anesthesia)and observation group(30 cases were treated with cervical plexus block combined with remifentanil propofol anesthesia).The changes of hemodynamic indexes at different time points were detected,and the incidence of adverse reactions was counted.The above data were compared between the two groups.Results The changes of blood oxygen saturation in the two groups were not significant at different time points(P>0.05).After cervical plexus block and skin suture,the changes of heart rate and average arterial pressure in the observation group were smaller than those in the control group,and the hemodynamics was more stable(P<0.05).The incidence of limb activity in the observation group was significantly lower than that in the control group(P<0.05),and the incidence of muscle rigidity,respiratory depression and nausea and discomfort in the two groups were compared(P>0.05).Conclusion Cervical plexus block combined with remifentanil and propofol anesthesia in thyroid tumor surgery is beneficial to maintain the stability of hemodynamic indexes of patients,ensure the safety and controllability of anesthesia,and ensure the smooth operation.It has the value of application and popularization.