芬太尼复合布比卡因用于颈丛阻滞的临床观察.pdfVIP

· 1818· 中国基层医药2007年11月第l4卷第11期 Chin j Prim Med Pham．November 2007，vo1．14，No．11 芬太尼复合布比卡因用于颈丛阻滞的临床观察 王恩斌 【摘要】 目的 观察芬太尼复合布比卡因用于颈丛阻滞对患者血流动力学的影响。方法 行甲状腺次 全切除术的患者40例。ASAI～Ⅱ级，随机分两组，试验组和对照组，每组各20例。实验组，0．25％布比卡 因10 ml加入芬太尼0．5／xg／kg；对照组，0．25％布比卡因10 ml。40例患者均采用双侧颈浅神经阻滞(c4、一 针法)。分别记录两组颈丛阻滞前，阻滞后5、10、15 min和20 min时所测SBP、DBP、HR变化。结果 两组阻 滞前血压和心率差异无统计学意义(P0．05)。收缩压，试验组阻滞后 10 min开始，有 10～20 mm Hg的波 动；对照组阻滞5 rain开始有10～20 mm Hg的波动，组内各时段之间比较差异有统计学意义(P0．05)，同 时段组间比较差异有统计学意义(P0．05)。舒张压两组均有上升，对照组上升略高于试验组，同时段组间 比较在15、20 min时段差异有统计学意义(P0．05)。心率在阻滞后试验组较平稳，对照组明显上升，同时段 组间比较差异有统计学意义(P0．05)，组内各时段之间比较差异有统计学意义(P0．05)。结论 布比卡 因复合芬太尼行颈丛阻滞用于甲状腺手术患者，能有效地控制心率和维持血压稳定。 【关键词】 布比卡因；芬太尼；颈丛；神经传导阻滞 Clinical application of bupivacaine combined with fentanyl in cervical plexus block WANG En—bin．Department ofAnesthesiology，Hospital ofWuhu County，Anhui 241100，China 【Abstract】0haective To investigate the effect of bupivacaine combined with fentanyl on the hemodynamics of thyroidectomy patients in cervical plexus block．Methods Forty thyroidectomy patients in ASA I～11 were ran— domly,divided into tWO groups with 20 cases in each．Patients in test group were i~ected with 0．25％ bupivacaine and 0．5t,g／kgfentanyl(10m1)．Patientsin controlgroupwereinjectedwith 0．25％bupivacaine(10m1)．Each patient was injected by tWO sides cervical plexus block．The changes of hemodynamics indexes，of the patients，systolic blood pressure(SBP) diastolic blood press(DBP)and heart rate(HR)，were recorded．Results There was no significant difference in blood pressure(BP)and HR between the tWO groups before—block(P0．05)．10～20mmHg SBP changes were observed from lOth minute and from 5th minute after-block in test group and in control group，respec— tively．There was significant difference in SBP at different time after—block compared to before—block in control group (P0．05)as well as between tWO groups at the same time after—block(P0．05)．DBP of every patient increased， especial