超声引导下星状神经节阻滞对全麻沙滩椅位肩关节镜手术患者术中rSOn 2的影响n

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目的:评价超声引导下星状神经节阻滞(SGB)对全麻沙滩椅位肩关节镜手术患者术中局部脑氧饱和度(rSOn 2)的影响。n 方法:择期行全麻沙滩椅位肩关节镜手术患者40例,性别不限,年龄18~64岁,ASA分级Ⅰ级或Ⅱ级,采用随机数字表法分为2组(n n=20):对照组(C组)和SGB组(S组)。术侧行超声引导下SGB,S组注射0.25%盐酸罗哌卡因6 ml,C组注射0.9%氯化钠溶液6 ml。SGB后改沙滩椅位,10 min后改平卧位行麻醉诱导,气管插管术后5 min改沙滩椅位开始手术。分别于入室平卧位5 min(Tn 0)、SGB后沙滩椅位5 min(Tn 1)、麻醉诱导后平卧位5 min(Tn 2)、麻醉诱导后沙滩椅位即刻(Tn 3)、麻醉诱导后沙滩椅位5、15和30 min(Tn 4-6)时记录rSOn 2,记录术中大脑去饱和事件(rSOn 2从基线降低大于或等于20%或在15 s内降至55%以下)发生情况。n 结果:2组各时点术侧和非术侧rSOn 2和术中大脑去饱和事件发生率比较差异无统计学意义(n P>0.05)。n 结论:超声引导下SGB对全麻沙滩椅位肩关节镜手术患者术中rSOn 2无影响。n “,”Objective:To evaluate the effect of ultrasound-guided stellate-ganglion block (SGB) on regional cerebral oxygen saturation (rSOn 2) in the patients undergoing arthroscopic shoulder surgery in the beach chair position (BCP) with general anesthesia.n Methods:Forty patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective arthroscopic shoulder surgery in the BCP with general anesthesia, were divided into 2 groups (n n = 20 each) using a random number table method: control group (group C) and SGB group (group S). SGB was performed on the operated side under ultrasound guidance, 0.25% ropivacaine 6 ml was injected in group S, and 0.9% sodium chloride 6 ml was given in group C. Patients were turned to BCP after SGB, and 10 min later the patients were placed in the supine position for induction of anesthesia.The patients were turned to BCP at 5 min after tracheal intubation, and then the operation was started.The rSOn 2 was recorded at 5 min of supine position after entering the operating room (Tn 0), 5 min of BCP after SGB (Tn 1), 5 min after anesthesia induction (Tn 2), immediately after BCP (Tn 3), and at 5, 15 and 30 min of BCP (Tn 4-6). The development of cerebral desaturation events (defined as a decrease in rSOn 2≥20% from baseline values or as a decrease in rSOn 2 below 55% within 15 s) was recorded.n Results:There was no significant difference in rSOn 2 on the operated and non-operated sides and incidence of intraoperative brain desaturation events at each time point between the two groups (n P>0.05).n Conclusion:Ultrasound-guided SGB had no effect on the intraoperative rSOn 2 in the patients undergoing arthroscopic shoulder surgery in the BCP with general anesthesia.n
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