超声引导下颈神经通路阻滞对甲状腺手术患者术后恢复质量的影响

来源 :国际麻醉学与复苏杂志 | 被引量 : 0次 | 上传用户:slow1223rabbit
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:探讨超声引导下双侧颈神经通路阻滞对甲状腺手术患者术后恢复质量的影响。方法:此试验为一项前瞻性、双盲、随机对照试验,选取择期全身麻醉下行甲状腺部分切除术的60例患者,按照随机数字表法将患者分为试验组(30例)和对照组(30例),麻醉诱导后两组分别行超声引导下的双侧颈神经通路阻滞和双侧颈浅丛阻滞。主要结局指标:术后24 h恢复质量[采用40项恢复质量评分(40-item Quality of Recovery Score, QoR-40)量表评价]。次要结局指标:术中丙泊酚和瑞芬太尼用量,医师操作满意度,入室稳定后(Tn 1)、阻滞后2 min(Tn 2)和切皮即刻(Tn 3)时心率和MAP变化,苏醒时间,苏醒期不良反应,PACU停留时间,术后0、4、8、24 h静息和运动(咳嗽)状态下疼痛数字评价(Numerical Rating Scale, NRS)量表评分。n 结果:试验组术后24 h QoR-40量表评分总分高于对照组(n P<0.05),其中在自理能力及疼痛的维度上,试验组高于对照组(n P<0.05)。试验组麻醉维持期瑞芬太尼用量小于对照组,医师操作满意度(VAS评分)高于对照组,Tn 1、Tn 2、Tn 3时的心率和MAP低于对照组,苏醒时间少于对照组,术后0、4、8 h静息时NRS评分低于对照组(n P0.05)。n 结论:甲状腺手术患者术前在超声引导下行双侧颈神经通路阻滞,有助于患者术后早期恢复。“,”Objective:To explore the effects of ultrasound-guided bilateral cervical nerve pathway block on the postoperative quality of recovery in patients undergoing thyroid surgery.Methods:This study was a prospective, double-blind, randomized controlled trial. According to the random number table method, 60 patients undergoing partial resection of the thyroid under general anesthesia were divided into the following group (n n=30): an experimental group and a control group. After anesthesia induction, patients in the two groups underwent ultrasound-guided bilateral cervical nerve pathway block and bilateral superficial cervical plexus block, respectively. The primary outcome was the quality of recovery 24 h after surgery [assessed by 40-item Quality of Recovery Score (QoR-40)]. The secondary outcomes included the consumption of propofol and remifentanil, endoscopist satisfaction, changes in heart rate and mean arterial pressure (MAP) when patients become stable in the operation room (Tn 1), 2 min after block (Tn 2), and immediately after skin incision (Tn 3), awakening time, adverse reactions during the recovery period, the length of postanesthesia care unit (PACU) stay, and the scores of Numerical Rating Scale (NRS) 0, 4, 8 h and 24 h after surgery at resting and during movement (coughing).n Results:The experimental group showed significant increases in QoR-40 score 24 h after operation, compared with the control group (n P<0.05), especially in the self-care ability and pain dimension (n P<0.05). Compared with the control group, the experimental group presented decreases in the consumption of remifentanil during anesthesia maintenance, increases in endoscopist satisfaction (VAS score), decreases in heart rate and MAP at Tn 1, Tn 2 and Tn 3, decreases in awakening time, and decreases in NRS scores at resting 0, 4 h and 8 h after surgery (n P0.05).n Conclusions:Ultrasound-guided bilateral cervical nerve pathway block in patients undergoing thyroid surgery is useful to improve the quality of recovery in the early postoperative period.
其他文献
湖南省广播电视局局长魏文彬人如其名,看起来是典型湘楚一带的文人模样。在今天的中国传媒界,这个有些瘦削的湖南人创造了一个奇迹——朝气蓬勃的电视“湘军”即由他一手打
霉菌在自然界分布很广,可以污染多种粮食和食品。其中有些霉菌的代谢产物,能对动物的神经、消化、泌尿及血液等系统引起毒害,这类物质统称为霉菌毒素。霉菌毒素引起人类急件
一切始于世博。人类崭新的城市时代,始于上海世博。举世瞩目的上海世博会,又在续写东西方的传奇故事。约会的主题是更美好的城市与生活,时值中国持续三十年的经济高速发展,
10月31日晚20时30分许,中国国务院总理温家宝宣布,中国2010年上海世界博览会闭幕。为期184天的上海世博会大幕落下。上海世博会是继北京奥运会后我国举办的又一国际盛会,也
在高温条件下工作的工人,由于外界环境空气温度的改变,体内物质代谢的强度和性质亦将发生变化、过去有许多研究报告,认为高温条件下机体对维生素B_1、维生素B_2和维生素C的
那么,在江淮地区如何应用截干蓄枝造型法呢?我认为有以下几点: 一、克服急躁思想,耐下心来:“急于观景”是初学者特有的通病。桩坯成活后,总是想早日成型观赏,于是忍不住反
雪松是园林主要观赏树种之一,在我国大部分地区都有栽培。繁殖雪松主要靠扦插育苗。经过多年反复试验,雪松采用全封闭扦插育苗,具有省工、省时、省投资,生根快且成活率高的
K&C近期推出一部MP3机,除了可以播放歌曲外,更新加了读字功能,无论中文、英文都可以显示,最合适喜欢看着歌词听歌的朋友。如果你喜欢,可以把整本小说放进去,出外时慢慢看。这
一神秀的古城滁州, 是一片生长大树高竹的沃土, 是一方盛产奇葩瑶草的仙境。自古滁州出才子。翻开历史的画卷,一位位名垂千古的诗人、文豪、鸿儒、书家,从锦绣的山城向我们
《海峡两岸经济合作框架协议》(ECFA)为两岸产业发展带来了新契机,其后续效应发挥仍需双方努力 6月29日,海协会与台湾海基会在重庆签署《海峡两岸经济合作框架协议》(ECFA)