气管内全麻合并颈丛阻滞应用于甲状腺手术的临床观察.pdfVIP

· 486· Journal of Trooical Medicine Vo1．8 No．5 Mav．2008 文章编号】1672—3619(2008)05．0486-03 · 临床研究论著 · 气管内全麻合并颈丛阻滞应用于甲状腺手术的临床观察 罗德兴，高晓枫，蓝胜文 (惠州市中心人民医院麻醉科，惠州 516001) 【摘要】 目的 对比气管内全麻合并颈丛阻滞和单纯气管内全麻应用于甲状腺手术的麻醉效果。方法 40例行双侧甲状腺次全切除手术的全麻患者，随机分为A、B两组，A组采用气管内全麻合并颈丛阻滞，B组采 用单纯气管内全麻，常规麻醉诱导插管，麻醉维持A组用瑞芬太尼0．05—0．15 g／(kg·min)，B组用瑞芬太尼 0．1—0．2 g／(kg·min)，两组均持续静脉输注异丙酚，记录气管插管、切皮、麻醉维持和气管拔管时血压和心率的 变化，术后睁眼和气管拔管时间，以及术后是否需要镇痛。结果 A组气管插管、切皮、麻醉维持时浅麻醉发生 率明显低于B组(P0．05)，B组术后需要镇痛的人数明显多于A组(P0．01)。结论 气管内全麻合并颈丛阻 滞在甲状腺手术时维持血流动力学稳定方面明显优于单纯气管内全麻．并可减轻术后疼痛。 【关键词】 甲状腺；气管内全麻 中图分类号：R581 文献标识码：B Clinical Application of Inhalation-Intravenous General Anesthesia Combined with Cervical Plexus Block in the Thyroid Surgery LUO De—xing，GAO Xiao—feng，LAN Sheng—wen (Department ofAnesthesiology，Central Peoples Hspital，Huizhou 516001，China) 【Abstract】 Objective To explore the effect of inhalation—intravenous general anesthesia combined with cervical plexus block in the thyroid surgery．Methods 40 Patients having elective thyroid surgery under general anesthesia were allocated randomly into two groups：group A and group B，with 20 patients in each group，group A adopted inhalation— intravenous general anesthesia combined with cervical plexus block，group B adopted tracheal general anesthesia．After tracheal intubation，the depth of Anesthesia was maintained by remifentanil 0．05—0．15 g／(kg·min)in group A，and remifentanil 0．1~0．2 I~g／(kg·min)in group B，followed by an intravenous infusion of propofo1．Heart rate and blood pressure were recorded at the following time points：at intubation，skin incision，anesthetic maintenance and extubation． Eye opening after operation and exintubation t