【摘要】 目的:以小剂量舒芬太尼复合三种不同局麻药用于颈丛神经阻滞,比较观察其麻醉效果和不良反应。方法:择期行甲状腺手术的患者90例,随机分为A组、B组、C组,每组30例。三组均于入室20min后行双侧C4横突一针法颈丛神经阻滞,局麻药分别用0.25%布比卡因(A组),0.25%罗哌卡因(B组),0.25%左旋布比卡因(C组),三组均加入舒芬太尼0.2μg/kg,混合液共20ml。每侧C4横突注药6ml,后退针至颈阔肌表面扇形注射4ml,双侧同时阻滞。记录颈丛神经阻滞前(T0)、颈丛神经阻滞5min(T1)、10min(T2)、15min(T3)、30min(T4)、60min(T5)时的SBP、DBP、HR、SpO2。结果:T1～T4时三组SBP、DBP、HR均明显高于T0时(P<0.05),T0～T4时三组之间比较差异无显著性(P>0.05);SpO2三组各时段之间比较差异无显著性(P>0.05),均维持于95%以上。三组患者麻醉效果优良率均为100%。结论:小剂量舒芬太尼复合布比卡因、罗哌卡因和左旋布比卡因用于颈丛神经阻滞均能增强麻醉效果,并使循环更趋稳定,但罗哌卡因和左旋布比卡因安全性更好一些。更多还原

【Abstract】 Objective:Use three different local anesthetics in cervical plexus block combined with sufentanil of low-dose to compare their efficiency and adverse reaction.Methods:90 patients undergoing elective thyroid surgery were randomly allocated into A group,B group and C group(each 30 cases).The patients of the three groups were all given cervical plexus block through C4 transverse of both sides by one needle method.The three local anesthetics were 0.25% bupivacaine(A group),0.25% ropivacaine(B group),0.25% levobupivacaine(C group).The three groups were all combined with sufentanil by 0.2μg/kg,and the mixture was 20ml.Each side of the C4 transverse was given 6ml,and gave 4ml fan-shapedly when the needle move back to the surface of the platysma muscle.Recorded the SBP,DBP,HR,SpO2.Before cervical plexus block(T0),and 5min after the block(T1) and 10min after(T2)15min after(T3)30min after(T4)60min after(T5).Results:The SBP,DBP,HR of the three groups were significantly higher at the time of T1~T4 than T0(P<0.05),and the difference between the three groups was not significant at the time of T0~T4(P>0.05);The difference of SpO2 of the three groups at all the time points was not significant(P>0.05),And the SpO2 were all maintained at 95% or higher.The anesthesia satisfaction rate of the three groups were all 100%.Conclusion:Low-dose sufentanil can enhance the anesthesia effect when combined with bupivacaine,ropivacaine and levobupivacaine in cervical plexus block,and make circulation more stable,but the ropivacaine and levobupivacaine were much more safer.更多还原