CAJ | 학술논문

目的：观察术前头部周围神经阻滞对颅脑手术中瑞芬太尼用量及术后疼痛的影响。方法：选择择期全麻下行幕上颅脑手术患者80例，随机分为两组，头部周围神经阻滞联合全麻组（S组）和单纯静脉全麻组（C组），每组40例。麻醉诱导插管后S组用0．596％甲磺酸罗哌卡因行眶上、滑车、耳颞、枕大和枕小神经以及对侧头钉所在的位置相应的神经阻滞。记录两组术中血流动力学相关指标、麻醉镇痛药的用量以及清醒拔管后0．5、2、6、12、24、48 h 的VAS值。结果：与C 组比较，上头架、关颅时S 组SBP、DBP、HR 明显降低（P＜0．05）；S组瑞芬太尼用量和手术清醒后0．5、2、6、12、24、48 h VAS S组均低于C组（P＜0．05），差异有统计学意义。结论：全身麻醉辅助术前头部周围神经阻滞在颅脑手术中能减少瑞芬太尼用量，减轻术后疼痛。
목적：관찰술전두부주위신경조체대로뇌수술중서분태니용량급술후동통적영향。방법：선택택기전마하행막상로뇌수술환자80례，수궤분위량조，두부주위신경조체연합전마조（S조）화단순정맥전마조（C조），매조40례。마취유도삽관후S조용0．596％갑광산라고잡인행광상、활차、이섭、침대화침소신경이급대측두정소재적위치상응적신경조체。기록량조술중혈류동역학상관지표、마취진통약적용량이급청성발관후0．5、2、6、12、24、48 h 적VAS치。결과：여C 조비교，상두가、관로시S 조SBP、DBP、HR 명현강저（P＜0．05）；S조서분태니용량화수술청성후0．5、2、6、12、24、48 h VAS S조균저우C조（P＜0．05），차이유통계학의의。결론：전신마취보조술전두부주위신경조체재로뇌수술중능감소서분태니용량，감경술후동통。
Objective To investigate the effects of the head peripheral nerve block on remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery. Methods 80 patients under general anesthesia undergoing supratentorial craniocerebral surgery were randomly divided into two groups:the head peripheral nerve block combined intravenous anesthesia group (group S, 40 cases) and the simple intravenous anesthesia group (group C, 40 cases). After anesthesia induction intubation, the patients in group S received the head peripheral nerve block with 0.596% ropivacaine mesylate injection,including supraorbital nerve, supratrochlear nerve , auriculotemporal nerve , great occipital nerve and lesser occipital nerve , as well as regional nerve on the corresponding position of the bilateral head nails. Haemodynamic index of the operations was measured;drug consumption during operation and VAS pain score at 0. 5, 2, 6, 12, 24 and 48 h after surgery were recorded. Results Compared with group C, the values of SBP, DBP, HR had a significant decrease at head-nail insertion and the latter stage in group S(P<0.05). The remifentanil consumption and VAS scores had a significant decrease in group S (P < 0.05). Conclution Head peripheral nerve block before operation could enhance anesthesic analgesia, reduce the remifentanil consumption and postoperative pain in patients undergoing craniocerebral surgery.