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[1]朱藝霞,王明虹.超聲引導(dǎo)下頭部周圍神經(jīng)阻滯在開顱手術(shù)中的應(yīng)用[J].福建醫(yī)藥雜志,2021,43(02):18-21.
　ZHU Yixia,WANG Minghong.Application of ultrasound-guided peripheral nerve block in craniotomy[J].FUJIAN MEDICAL JOURNAL,2021,43(02):18-21.
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超聲引導(dǎo)下頭部周圍神經(jīng)阻滯在開顱手術(shù)中的應(yīng)用()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期數(shù):
2021年02期
頁碼:
18-21
欄目:
臨床研究
出版日期:
2021-04-15

文章信息/Info

Title:
Application of ultrasound-guided peripheral nerve block in craniotomy
文章編號:
1002-2600(2021)02-0018-04
作者:
朱藝霞; 王明虹
福建醫(yī)科大學(xué)附屬寧德市醫(yī)院麻醉科(寧德 352100)
Author(s):
ZHU Yixia;  WANG Minghong
Department of Anesthesiology,Ningde Hospital Affiliated to Fujian Medical University,Ningde,Fujian 352100,China
關(guān)鍵詞:
超聲;  頭部周圍神經(jīng)阻滯;  開顱;  血流動(dòng)力學(xué);  應(yīng)激反應(yīng)
Keywords:
ultrasound;  peripheral nerve block;  craniotomy;  hemodynamics;  stress response
分類號:
R614
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 通過觀察超聲引導(dǎo)下頭部周圍神經(jīng)阻滯對開顱手術(shù)患者血流動(dòng)力學(xué)、應(yīng)激反應(yīng)的影響,探討其臨床價(jià)值。方法 60例顱內(nèi)占位患者隨機(jī)分為兩組,對照組30例采取全身麻醉,觀察組30例于全身麻醉前行超聲引導(dǎo)下頭部周圍神經(jīng)阻滯。比較兩組術(shù)中不同時(shí)間點(diǎn)心率、平均動(dòng)脈壓水平,并測定血漿皮質(zhì)醇、血管緊張素Ⅱ、血糖水平評估應(yīng)激反應(yīng),統(tǒng)計(jì)兩組術(shù)中麻醉藥物丙泊酚、鎮(zhèn)痛藥物使用總量及不良反應(yīng)發(fā)生情況。結(jié)果 同組內(nèi)與T0比較,T2、T3、T4時(shí)刻觀察組MAP、HR水平差異無統(tǒng)計(jì)學(xué)意義(P>0.05),對照組MAP、HR水平升高(P<0.05); 與觀察組比較,對照組T2、T3、T4時(shí)刻MAP、HR水平升高(P<0.05)。同組內(nèi)與T0比較,觀察組T1、T2、T3、T4時(shí)刻皮質(zhì)醇、血管緊張素Ⅱ水平均降低(均P<0.05); 與對照組比較,觀察組T2、T3、T4時(shí)刻皮質(zhì)醇、血管緊張素Ⅱ、血糖水平均降低(均P<0.05)。兩組手術(shù)時(shí)間比較差異無統(tǒng)計(jì)學(xué)意義(P>0.05); 觀察組丙泊酚及瑞芬太尼使用總量均低于對照組(均P<0.05); 觀察組術(shù)中不良反應(yīng)發(fā)生率低于對照組(P<0.05)。結(jié)論 超聲引導(dǎo)下頭部周圍神經(jīng)阻滯有助于維持開顱手術(shù)患者血流動(dòng)力學(xué)穩(wěn)定,并減輕應(yīng)激反應(yīng),減少不良反應(yīng)。
Abstract:
Objective To investigate the clinical value of ultrasound-guided peripheral nerve block on hemodynamics and stress response in patients undergoing craniotomy.Methods A total of 60 patients with intracranial space occupying were randomly divided into two groups, 30 patients in the control group received general anesthesia, and 30 patients in the observation group received ultrasound-guided peripheral head nerve block before general anesthesia.The heart rate and average arterial pressure at different time points in the two groups were compared, and the plasma cortisol, angiotensin Ⅱ and blood glucose levels were measured to assess the stress response.The total amount of anesthetic propofol and analgesic drugs used and the occurrence of adverse reactions in the two groups were calculated.Results Compared with T0 in the same group, there was no statistically significant difference in MAP and HR levels of the observation groups at T2, T3 and T4(P<0.05),and the levels of MAP and HR in the control group increased(P<0.05); Compared with the observation group, the levels of MAP and HR in the control group increased at T2, T3 and T4(P<0.05).In the observation group, cortisol and angiotensin Ⅱ levels were all reduced at T1, T2, T3 and T4 compared with those at T0(P<0.05); Compared with the control group, cortisol, angiotensin Ⅱ and blood glucose levels in the observation group were all reduced at T2, T3 and T4(P<0.05).There was no significant difference in operation time between the two groups(P<0.05).The total amounts of propofol and remifentanil in the observation group were lower than those in the control group(P<0.05).The incidence of intraoperative adverse reactions in the observation group was lower than that in the control group(P<0.05). Conclusion Ultrasound-guided peripheral nerve block is helpful to maintain hemodynamic stability in patients undergoing craniotomy, reduce stress response and adverse reactions.

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更新日期/Last Update: 2021-04-15