超声引导下C4神经根加颈浅丛阻滞在微创甲状旁腺手术中的应用

发布时间：2018-03-06 11:09

本文选题：超声引导　切入点：颈神经根阻滞　出处：《中国医学科学院学报》2017年05期 　论文类型：期刊论文

【摘要】：目的评估超声引导下C4神经根阻滞联合颈浅丛阻滞对微创甲状旁腺腺瘤切除术的麻醉效果。方法纳入35例甲状旁腺功能亢进、拟行微创甲状旁腺腺瘤切除手术的患者,在超声实时引导下,在C4神经根后给予0.5%罗哌卡因+1%利多卡因混合液3~4 ml,胸锁乳突肌深层给予药液5~6 ml,阻滞颈浅丛,同时复合右美托咪定输注进行镇静,阻滞后进行温度及疼痛感觉评估。结果所有患者均无须改变麻醉方式,未出现局麻药入血,无椎管内注射。6例(17.1%)患者在阻滞后出现声音嘶哑,3例(8.6%)出现Horner综合征。阻滞后10 min中位温感数字评分法评分为1.2[0,5]分,患者满意度评分平均为9.5分。结论超声引导下C4神经根加颈浅丛阻滞因阻滞目标更明确,可以较少的药量达到较好的阻滞效果,配合适度的术中镇静,可安全、有效地用于微创甲状旁腺腺瘤切除术麻醉。
[Abstract]:Objective to evaluate the anesthetic effect of ultrasound guided C4 nerve root block combined with superficial cervical plexus block on minimally invasive resection of parathyroid adenoma. Under the real-time guidance of ultrasound, 0.5% ropivacaine 1% lidocaine was given to C 4 nerve root with 3 ~ 4 ml of lidocaine, and 5 ~ 6 ml of sternocleidomastoid muscle was given deep to block the superficial cervical plexus, and combined with dexmetomidine for sedation. Temperature and pain sensation were assessed after block. Results all patients did not need to change the anesthetic method, and no local anesthetic was found to enter blood. Horner syndrome was found in 3 patients with hoarseness after block 10 min after block. Conclusion Ultrasound-guided C _ 4 nerve root and superficial cervical plexus block has a more definite target and can achieve a better block effect with less drug dose, combined with moderate intraoperative sedation, it is safe, and the score of patients' satisfaction is 9.5.Conclusion Ultrasound-guided C _ 4 nerve root block with superficial cervical plexus block is safe. Effective anesthesia for minimally invasive resection of parathyroid adenoma.
【作者单位】：中国医学科学院北京协和医学院北京协和医院麻醉科;中国医学科学院北京协和医学院北京协和医院基本外科;
【基金】：北京协和医学院创新团队发展计划~~
【分类号】：R614

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