颈部迷走神经阻滞在胃肠手术中预防术中反射性心动过缓的研究进展

Research Progress of Cervical Vagus Nerve Block in the Prevention of Reflex Bradycardia during Gastrointestinal Surgery

随着腔镜技术的快速发展,越来越多的胃肠手术得以在更微创的条件下进行。但由于腔镜手术大多在全身麻醉下进行,使得交感神经被抑制,而胃肠手术中的牵拉和CO2气腹又会进一步导致迷走神经兴奋,引起血压降低、心率减慢或心律不齐等,甚至有可能出现休克、心跳骤停等一系列症状。而迷走神经阻滞可以减少术中因手术操作或药物引起的迷走神经兴奋而导致的心动过缓和/或血压下降,且操作简便,安全性高,适用人群较广。所以本文旨在探讨颈部迷走神经阻滞用于预防胃肠手术中由迷走神经介导的心动过缓、血压下降等不良反应的研究进展,为后续相关研究提供参考。

With the rapid development of endoscopy technology, more and more gastrointestinal surgery can be performed under less invasive conditions. However, since endoscopic surgery is mostly per-formed under general anesthesia, the sympathetic nerve is suppressed, and the traction and CO2 pneumoperitoneum in gastrointestinal surgery will further lead to vagus nerve excitation, resulting in lower blood pressure, slow heart rate or arrhythmia, and even a series of symptoms such as shock and cardiac arrest. Vagus nerve block can reduce bradycardia and/or blood pressure drop caused by vagus nerve excitation caused by surgery or drugs, and it is simple to operate, high safety, and suitable for a wide range of people. Therefore, this paper aims to discuss the research progress of cervical vagus nerve block in preventing vagus-mediated bradycardia, blood pressure drop and other adverse reactions in gastrointestinal surgery, and provide reference for subsequent relevant studies.