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  • 星狀神經(jīng)節(jié)阻滯與全麻插管期心血管反應(yīng)

    【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?!〗Y(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(Plt;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(Plt;0.01);窺喉時(shí)SBP、DBP、MBP、HR、RPP均顯著升高(Plt;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(Plt;0.05或Plt;0.01)?!〗Y(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 (Plt;0.01) and recovered three minutes after the intubation. In the control group 1 and 2, SBP, MAP, and DBP decreased significantly after induction (Plt;0.01); SBP, MAP, DBP, HR and RPP increased apparently at the laryngeal exposure compared with the baseline values (Plt;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 (Plt;0.05 or Plt;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.

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