CAJ | 학술논문

目的：探讨一种能达到舒适医疗目的的颈丛麻醉的辅助麻醉方案。方法将80例择期行双侧甲状腺手术的女性患者分为对照组（A组）、氟芬组（B组）、布托啡诺组（C组）、右美托咪定联合芬太尼组（D组），每组20例。记录各组颈丛阻滞前10 min（T0）、颈丛操作（T1）、切皮（T2）、分离甲状腺下极（T3）、缝皮（T4）的收缩压（SBP）、舒张压（DBP）、心率（HR）、血氧饱和度（SpO2）、Narcotrend麻醉／脑电意识深度监测指数（NTI）。结果 B组和A组同时点比较差异无统计学意义（P＞0．05）；C组在T3、T4时点SBP、DBP、HR高于 T0，同时点上较 A组、B组有所降低且差异有统计学意义（P＜0．05）；D组 T2、T3、T4时点的HBP、DBP、HR较T1下降，差异有统计学意义（P＜0．05）；D组在T3、T4时点上的SBP、HDP、HR较其他3组下降，差异有统计学意义（P＜0．05）；D组NTI在T1、T2时点与A组、B组比较，差异有统计学意义（P＜0．05），在T3、T4时点较其他3组镇静效果好，差异有统计学意义（P＜0．05）。结论颈丛神经阻滞辅以右美托咪定行甲状腺手术能降低患者的应激反应，有适度的镇静、痛效果，可达到舒适医疗的目的。
목적：탐토일충능체도서괄의료목적적경총마취적보조마취방안。방법장80례택기행쌍측갑상선수술적녀성환자분위대조조（A조）、불분조（B조）、포탁배낙조（C조）、우미탁미정연합분태니조（D조），매조20례。기록각조경총조체전10 min（T0）、경총조작（T1）、절피（T2）、분리갑상선하겁（T3）、봉피（T4）적수축압（SBP）、서장압（DBP）、심솔（HR）、혈양포화도（SpO2）、Narcotrend마취／뇌전의식심도감측지수（NTI）。결과 B조화A조동시점비교차이무통계학의의（P＞0．05）；C조재T3、T4시점SBP、DBP、HR고우 T0，동시점상교 A조、B조유소강저차차이유통계학의의（P＜0．05）；D조 T2、T3、T4시점적HBP、DBP、HR교T1하강，차이유통계학의의（P＜0．05）；D조재T3、T4시점상적SBP、HDP、HR교기타3조하강，차이유통계학의의（P＜0．05）；D조NTI재T1、T2시점여A조、B조비교，차이유통계학의의（P＜0．05），재T3、T4시점교기타3조진정효과호，차이유통계학의의（P＜0．05）。결론경총신경조체보이우미탁미정행갑상선수술능강저환자적응격반응，유괄도적진정、통효과，가체도서괄의료적목적。
Objective To explore a kind of comfortable medical for ervical plexus anesthesia auxiliary anesthesia .Methods 80 thyroidectomy female patients were randomly divided into normal saline group (group A) ,droperidol-fentanyl group (group B) ,bu-torphanol group (group C) ,dex group (group D) ,20 cases in each group .The change of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,heart rate (HR) ,blood oxygen saturation (SpO2 ) ,narcotrend index (NTI) were monitored .The above pa-rameters were recorded at 10 min before cervical plexus(T0 ) ,cervical plexus operation(T1 ) ,skin incision(T2 ) ,separation of thyroid upper extreme(T3 )and suture(T4 ) .Results There was no significant difference between the groups A and B at the same time point (P>0 .05) .In group C ,the SBP、DBP、HR at T3 and T4 were significant higher than at T0 ,and at the same point the A and B group decreased statistically significant (P<0 .05) .In group D ,the SBP、DBP、HR at T2 、T3 、T4 were significant lower than at T1 ,espe-cially at T4 compared to at T0 (P<0 .05) .Compared to group A ,B ,C ,the SBP、DBP、HR in group D were lower at T3 and T4(P<0 .05) .NTI in group D at T1 、T2 had significant difference compared with group A and B (P<0 .05) ,especially at T3 、T4 were sta-tistically significant than the other three groups(P<0 .05) ,sedation was better than the other groups .Conclusion Cervical plexus block supplemented by dex can reduce the patient′s stress response and reach moderate sedation analgesia to comfortable medical purposes .