无肌松药气管插管联合右侧星状神经节阻滞在口咽部手术中的应用

摘要

观察无肌松药气管插管联合右侧星状神经节阻滞(SGB)在口咽部手术中应用的可行性与安全性.择期全身麻醉下行口咽部手术患者60例,随机分为无肌松药全麻诱导组(无肌松组)和无肌松药全麻诱导联合右星状神经节阻滞组(联合组),每组30例.记录患者诱导前(T0)、气管插管前即刻(T1)、气管插管后即刻(T2)、手术开始即刻(L)时的平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼吸末二氧化碳浓度(PETCO2);及患者手术后4、8、12、24 h各时点的VAS评分.结果显示两组气管插管满意率及术后苏醒差异无统计学意义.联合组在T2和T3时点的MAP和HR较无肌松组有明显降低;且在T2及T3时点HR减慢,联合组术后各时点的VAS评分较无肌松组降低,差异有统计学意义(P＜0.05).无肌松药气管插管联合右侧星状神经节阻滞可提供良好的气管插管条件,且血流动力学平稳,术后苏醒优良,并能减轻术后咽痛.%To observe the feasibility and safety of general anesthesia without muscle relaxant tracheal intubation combined with right stellate ganglion block (SGB) on patients undergoing oropharyngeal surgery.60 patients undergoing selective oropharyngeal surgery were randomly and equally divided into 2 groups:named in non muscle relaxation group and combination group.MAP,HR,SpO2 and PETCO2 were recorded before administration (T0),immediately before tracheal intubation(T1),and immediately after tracheal intubation(T2),and immediately after skin incision (T3).The VAS score at 4,8,12,24 h after surgery were also recorded.The difference of the satisfactory intubation conditions was not statistically significant.MAP and HR were increased at T2 and T3 as compared with non muscle relaxation group.Compared with combination group,HR increased at T2 and T3 in group A.The VAS of patients in combination group was lower than non muscle relaxation group (P ＜ 0.05).Stellate ganglion block on patients undergoing oropharyngeal surgery in general anesthesia without muscle relaxant might provide not only satisfactory intubation conditions but also provoke earlier recovery and improve the quality of postoperartive analgesia.