摘要:
目的 探讨甲状腺手术中应用超声引导颈丛麻醉联合全身麻醉的效果.方法 选取2014年8月—2016年8月就诊我院的66例行甲状腺手术患者,随机分为观察组与对照组各33例.对照组患者采取全身麻醉,观察组患者采取超声引导颈丛麻醉联合全身麻醉.比较两组患者手术时间、拔管时间、麻醉时间、术毕至患者睁眼时间、定向力恢复时间、全身麻醉维持用药量、复苏后不良反应.记录患者术后2h、4h、8h、12h、24h的视觉模拟量表(VAS)疼痛评分及镇静评分.结果 观察组患者使用瑞芬太尼、丙泊酚的用量均明显低于对照组,差异均有统计学意义(P<0.05);观察组患者术后2h、4h的镇静评分明显低于对照组,差异有统计学意义(P<0.05);观察组患者术后2h、4h、8h、12h、24h的VAS疼痛评分均明显低于对照组,差异均有统计学意义(P<0.05);观察组患者术后苏醒期躁动发生率明显低于对照组,差异有统计学意义(P<0.05).结论 超声引导颈丛麻醉联合全身麻醉可有效提高行甲状腺手术患者的麻醉效果,减少麻醉药物用量,具有较好的镇痛、镇静效果,且安全性较高,值得在临床上应用推广.%Objective To investigate the effect of ultrasound guided cervical plexus anesthesia combined with general anesthesia in thyroid surgery. Methods In August 2014 to August 2016 clinic of our hospital,66 patients undergoing thyroid surgery were randomly divided into observation group and control group (33 cases). Control group of patients taking general anesthesia,observation group of patients taking ultrasound guided cervical plexus and general anesthesia. Compare two groups of surgical operation time,extubation time,anesthesia time,stopped taking the drug to patients with open time,directional force recovery time and patients with general anesthesia maintaining dose,adverse reactions. The visual analogue scale (VAS)pain score and sedation score were recorded at 2h,4h,8h,12h and 24h after operation. Results The observation group of patients using fentanyl,propofol dosage were significantly lower than the control group,compared with significant difference,statistically significant (P < 0. 05);Observation group of patients after 2h,4h VAS score significantly lower than the control group, compared with significant difference,statistically significant (P < 0. 05);Observation group of patients after 2h,4h,8h,12h,24h sedation scores were significantly lower than the control group,the more significant difference,statistically significant (P < 0. 05);The resurgence of the observation group of patients with postoperative period of agitation rate significantly lower than the control group,the more significant difference,statistically significant (P < 0. 05). Conclusion Ultrasound guided cervical plexus anesthesia combined with general anesthesia can effectively improve the effect of general anesthesia in patients undergoing thyroid surgery,reduce the amount of narcotic drugs,have good analgesic effect,sedation effect and high safety,and should be popularized in clinical application.