星状神经节阻滞对鼻内窥镜手术患者术后睡眠障碍的影响

Effect of stellate ganglion block on postoperative sleep disturbance in patients undergoing nasal endoscopic surgery

目的探讨星状神经节阻滞(SGB)对鼻内窥镜手术患者术后睡眠障碍的影响。方法择期全麻行鼻内窥镜手术患者58例,随机分为两组,每组29例。麻醉诱导前30 min,观察组行超声引导下SGB,对照组不行SGB。比较两组术前1 d以及术后1、3、5 d匹兹堡睡眠指数(PSQI)评分。记录两组术后1 d的夜间总睡眠时间、睡眠效率和清醒次数。术后24 h评估VAS疼痛评分。观察SGB相关并发症,并记录术后24 h内需要补救镇痛的例数。结果与对照组比较,观察组术后1 d的夜间总睡眠时间延长,睡眠效率提高,夜间睡眠过程中清醒次数减少(P<0.05)。与术前1 d比较,对照组患者术后1、3 d的PSQI评分升高,观察组术后3、5 d的PSQI评分降低(P<0.05)。观察组术后1、3、5 d的PSQI评分均低于对照组(P<0.05)。观察组术后24 h的VAS疼痛评分低于对照组(P<0.05)。两组补救镇痛和恶心、呕吐比例差异无统计学意义(P>0.05)。结论SGB可有效改善鼻内窥镜手术患者术后睡眠质量,减轻术后疼痛。

Objective To explore the effect of stellate ganglion block(SGB)on postoperative sleep disturbance in the patients undergoing nasal endoscopic surgery.Methods Fifty-eight patients undergoing elective nasal endoscopic surgery under general anesthesia were divided into two groups with 29 cases each.Ultrasound-guided SGB was performed at 30 minutes before anesthesia induction in group A,which was not in group C as the control.The Pittsburgh Sleepiness Quotient Index(PSQI)scores on one day preoperatively,and on the 1^(st),3^(rd)and 5^(th)day postoperatively were compared between the two groups.The total sleep time,sleep efficiency and number of wakefulness were recorded on one day after surgery.VAS pain score was evaluated at 24 hours after operation.The SGB-related complications were observed and the cases needed remedial analgesia in 24 hours postoperatively were recorded.Results Compared with group C,group A had longer total nighttime sleep time with improved sleep efficiency and decreased number of wakefulness during nighttime sleep in one day postoperatively(P<0.05).Compared with one day before operation,the PSQI scores of group C were increased on the 1^(st)and 3^(rd)day postoperatively,and the PSQI scores of group A were decreased on the 3^(rd)and 5^(th)day postoperatively(P<0.05).The PSQI scores of group A were lower than those of group C on the 1^(st),3^(rd)and 5^(th)day postoperatively(P<0.05).The VAS pain score of group A was lower than that of group C at 24 hours postoperatively(P<0.05).There were no significant differences in the number of the cases needed remedial analgesia and the incidence rate of nausea and vomiting between the two groups(P>0.05).Conclusion In the patients undergoing nasal endoscopic surgery,SGB can effectively improve postoperative sleep quality and reduce postoperative pain.