甲状腺切除手术麻醉中应用右美托咪定辅助颈丛神经阻滞对维持血流动力学的效果分析

发布时间：2018-03-14 09:35

本文选题：甲状腺切除手术　切入点：右美托咪定　出处：《中国地方病防治杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨甲状腺切除手术麻醉中应用右美托咪定辅助颈丛神经阻滞的效果,并观察其对血流动力学的影响。方法90例行甲状腺切除手术患者,按照随机数字表法分为对照组与观察组,各45例。两组患者均采用颈丛神经阻滞麻醉;对照组辅助泵注咪达唑仑;观察组辅以泵注右美托咪定。于不同时间点观察两组患者血液流动力学(MAP、HR、SpO2)变化,分别采用Ramsay评分及视觉模拟评分(VAS)评价两组患者镇静、镇痛效果,统计不良反应情况。结果观察组不同时间点各项血液流动力学指标水平比较,差异无统计学意义(P0.05);对照组不同时间点各项血液流动力学指标比较,差异具有统计学意义(P0.05);且于切皮即刻、处理甲状腺上极时MAP及HR明显高于观察组,差异具有统计学意义(P0.05)。观察组于分离甲状腺上极及缝皮时Ramsay评分得分明显高于对照组,而VAS评分明显低于对照组,差异具有统计学意义(P0.05)。观察组各项不良反应发生率明显低于对照组,差异具有统计学意义(P0.05)。结论于甲状腺切除手术中应用右美托咪定辅助颈丛神经阻滞可有利于维持患者血液流动力学稳定,同时还具有较好的镇静、镇痛效果,降低不良反应发生,值得临床推广应用。
[Abstract]:Objective to investigate the effect of dexmetomidine on cervical plexus block during thyroidectomy anesthesia, and to observe its effect on hemodynamics. According to the method of random number table, the patients were divided into control group (n = 45) and observation group (n = 45). The patients in both groups were anesthetized by cervical plexus nerve block, and midazolam was injected into the control group. The patients in the observation group were injected with dexmetomidine. The changes of blood flow mechanics MAPHR-SpO2 were observed at different time points, and the sedative and analgesic effects of the two groups were evaluated by Ramsay score and visual analogue score respectively. Results there was no significant difference in the levels of blood flow mechanics at different time points in the observation group, and there was no significant difference between the two groups (P 0.05), while in the control group, the indexes of blood flow mechanics at different time points were compared. The difference was statistically significant (P 0.05), and the MAP and HR were significantly higher in the treatment of thyroid superior pole than in the observation group (P 0.05). The Ramsay score of the observation group was significantly higher than that of the control group in separating the superior thyroid pole and the suture skin. The VAS score was significantly lower than that in the control group, and the difference was statistically significant (P 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group. Conclusion the application of dexmetomidine in cervical plexus block during thyroidectomy is beneficial to maintain the stability of blood flow mechanics, and has good sedative and analgesic effects. Reduce the occurrence of adverse reactions, worthy of clinical application.
【作者单位】：绍兴文理学院附属医院麻醉科;
【分类号】：R614

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