超声引导下颈神经通路阻滞对腔镜甲状腺手术患者术后恢复质量的影响

Effect of ultrasound-guided cervical nerve pathway block on quality of postoperative recovery in patients undergoing laparoscopic thyroid surgery

目的基于腔镜甲状腺手术患者探讨并评估超声引导下颈神经通路阻滞技术的效果。方法选择2023年6月—2023年8月于郑州大学附属郑州中心医院进行择期全身麻醉下腔镜甲状腺手术的患者,按照1∶1的比例被随机分配到试验组和对照组。试验组的患者接受超声引导下的颈神经通路阻滞治疗,而对照组的患者则仅接受了全身麻醉。采用SPSS 23.0软件分析两种手术方案的术后恢复质量、麻醉药物的消耗量、静息和运动下的VAS评分及术后恶心呕吐的发生率。结果试验组术后24 h 15项恢复质量量表(quality of recovery-15 scale,QOR-15)评分总分为(139.25±6.28)分,高于对照组总分(132.53±6.30)分,差异有统计学意义(t=4.782,P<0.05);试验组的舒芬太尼(28.75±7.66 vs 35.62±8.02)、瑞芬太尼(0.97±0.33 vs 1.31±0.53)及羟考酮(0.58±1.30 vs 1.48±2.03)的使用量均少于对照组,差异有统计学意义(P<0.05);试验组静息和运动状态下手术结束时、1 h和6 h的VAS评分均显著低于对照组,差异有统计学意义(P<0.05)。两组患者的恶心呕吐不良反应发生率(15%vs 25%)比较,差异无统计学意义(χ^(2)=1.250,P=0.264)。结论超声引导下颈神经通路阻滞有助于腔镜甲状腺手术患者术后快速康复,具有良好的应用前景。

Objective To explore and assess the clinical efficacy of ultrasound-guided cervical nerve pathway block based on patients undergoing laparoscopic thyroid surgery.Methods The patients who underwent endoscopic thyroid surgery under elective general anesthesia in Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2023 to August 2023 were selected.Using a 1∶1 ratio,patients were randomly assigned to either the experimental group,receiving ultrasound-guided cervical nerve pathway block,or the control group,receiving only general anesthesia.Postoperative recovery quality,consumption of anesthetic drugs,resting and exercise VAS score,and incidence of postoperative nausea and vomiting were compared between the two groups using SPSS 23.0.Results The total 24-hour postoperative QOR-15 score was higher in the experimental group(139.25±6.28)compared to the control group(132.53±6.30)(t=4.782,P<0.05).Additionally,the experimental group required significantly less sufentanil(28.75±7.66 vs 35.62±8.02),remifentanil(0.97±0.33 vs 1.31±0.53),and oxycodone(0.58±1.30 vs 1.48±2.03)compared to the control group(P<0.05).Furthermore,VAS scores at the end of surgery,1 hour postoperatively,and 6 hours postoperatively,both at rest and during exercise,were significantly lower in the experimental group compared to those in the control group(P<0.05).There was no statistically significant difference in the incidence of nausea and vomiting between the two groups(15%vs 25%)(χ^(2)=1.250,P=0.264).Conclusion Ultrasound-guided cervical nerve pathway block enhances the rapid recovery of patients undergoing endoscopic thyroid surgery and shows promising application potential.