【摘要】　目的　 觀察右星狀神經(jīng)節(jié)阻滯（R-SGB）對(duì)全身麻醉氣管內(nèi)插管期心血管反應(yīng)的影響。　方法　 2009年10-12月選取60例美國(guó)麻醉醫(yī)師協(xié)會(huì)（ASA）Ⅰ、Ⅱ級(jí)擇期全麻手術(shù)患者，隨機(jī)分為3組。研究組于全麻誘導(dǎo)前15 min用1%利多卡因10 mL經(jīng)頸6入路行R-SGB，對(duì)照組1誘導(dǎo)前同法注射10 mL生理鹽水，對(duì)照組2誘導(dǎo)前肌注2%利多卡因5 mL。觀察氣管插管前后收縮壓（SBP）、舒張壓（DBP）、平均動(dòng)脈壓（MBP）、心率（HR）、心電圖（ECG）、氧飽和度（SpO2）和心率收縮壓乘積（RPP）的變化。　結(jié)果　 研究組各時(shí)點(diǎn)與進(jìn)入手術(shù)室時(shí)的基礎(chǔ)值比較，僅誘導(dǎo)后SBP、DBP、MBP顯著降低，窺喉時(shí)HR和RPP顯著升高（P lt;0.01）；在插管3 min后已恢復(fù)至基礎(chǔ)值。對(duì)照組1和對(duì)照組2誘導(dǎo)后SBP、DBP、MBP顯著降低（P lt;0.01）；窺喉時(shí)SBP、DBP、MBP、HR、RPP均顯著升高（P lt;0.01），并持續(xù)至插管后5 min。兩對(duì)照組升高的程度均顯著高于研究組（P lt;0.05或P lt;0.01）。　結(jié)論　 R-SGB對(duì)全麻氣管插管期的心血管反應(yīng)有一定抑制作用，可用于調(diào)控全麻插管期心血管不良反應(yīng)。
【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 (SpO2) 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 lt;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 lt;0.01); SBP, MAP, DBP, HR and RPP increased apparently at the laryngeal exposure compared with the baseline values (P lt;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 lt;0.05 or P lt;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.

引用本文： 陳華梅,廖琪. 星狀神經(jīng)節(jié)阻滯與全麻插管期心血管反應(yīng). 華西醫(yī)學(xué), 2011, 26(1): 66-68. doi: 復(fù)制

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