【摘要】 目的观察右星状神经节阻滞(R-SGB)对全身麻醉气管内插管期心血管反应的影响。方法 2009年10 12月选取60例美国麻醉医师协会(ASA)Ⅰ、Ⅱ级择期全麻手术患者,随机分为3组。研究组于全麻诱导前15min用1%利多卡因10mL经颈6入路行R-SGB,对照组1诱导前同法注射10mL生理盐水,对照组2诱导前肌注2%利多卡因5mL。观察气管插管前后收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)、心率(HR)、心电图(ECG)、氧饱和度(SpO2)和心率收缩压乘积(RPP)的变化。结果研究组各时点与进入手术室时的基础值比较,仅诱导后SBP、DBP、MBP显著降低,窥喉时HR和RPP显著升高(P<0.01);在插管3min后已恢复至基础值。对照组1和对照组2诱导后SBP、DBP、MBP显著降低(P<0.01);窥喉时SBP、DBP、MBP、HR、RPP均显著升高(P<0.01),并持续至插管后5min。两对照组升高的程度均显著高于研究组(P<0.05或P<0.01)。结论 R-SGB对全麻气管插管期的心血管反应有一定抑制作用,可用于调控全麻插管期心血管不良反应。更多还原

【Abstract】 Objective To explore the effect of right stellate ganglion block(R-SGB) on cardiovascular response during endotracheal intubation under the general anesthesia.Methods Sixty ASAⅠ-Ⅱpatients who underwent general anaesthesia between October to December 2009 were randomly divided into three groups.The patients in the trial group accepted R-SGB by C6 route with 1% lidocaine(10 mL) 15 minutes before induction of general anesthesia;the patients in control group 1 were injected with 10 mL physiological saline in the same way before the induction;the patients in control group 2 underwent the intramuscular injection of 2% lidocaine(5 mL) before the induction.The changes of systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),hear rate(HR),electrocardiogram(ECG),oxygen saturation(SpO2) and heart rate-systolic blood pressure product(RPP) before and after endotracheal intubation were observed and recorded.Results In the trial group,SBP,MAP,and DBP decreased significantly after the induction;HR and RPP increased evidently at the laryngeal exposure compared with the baseline values(P<0.01) and recovered three minutes after the intubation.In the control group 1 and 2,SBP,MAP,and DBP decreased significantly after induction(P<0.01);SBP,MAP,DBP,HR and RPP increased apparently at the laryngeal exposure compared with the baseline values(P<0.01),and the raise continued until five minutes after endotracheal intubation.The difference in the raise between the control groups and the trial group was significant(P<0.05 or P<0.01).Conclusion R-SGB may effectively inhibit the cardiovascular response during endotracheal intubation under the general anesthesia and can be used to control the negative reaction during the induction.更多还原