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颈浅丛神经阻滞在甲状腺全切术后的应用:一项随机试验。

Superficial selective cervical plexus block following total thyroidectomy: a randomized trial.

机构信息

Third Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Head Neck. 2010 Aug;32(8):984-8. doi: 10.1002/hed.21286.

Abstract

BACKGROUND

Pain after thyroid surgery is of moderate intensity and short duration. Bilaterally superficial cervical plexus block (BSCPB) may reduce analgesic requirements. However, its effectiveness in decreasing pain after thyroidectomy is debated.

METHODS

This double-blind, randomized placebo-controlled study in 100 patients undergoing total thyroidectomy evaluates the effects of BSCPB done with 20 mL of 0.75% ropivacaine. Additional parecoxib was administrated immediately postoperatively and 12 hours later.

RESULTS

Postoperative pain was assessed by visual analogue rating scale. All parameters were recorded at 0, 3, 6, 9, 12, and 24 hours after surgery. The control group had higher values than the ropivacaine group at all moments (p < .05) except H12 (p = .76). Additional analgesia was needed for 7 patients (14%) in the control group and for 8 patients (16%) in the group with ropivacaine (p = .96).

CONCLUSION

Two-point bilateral BSCPB has a major analgesic effect on patients after total thyroidectomy, with a statistically significant reduction in postoperative pain scores. However, no significant difference was noted in the proportion of patients that required additional analgesics.

摘要

背景

甲状腺手术后的疼痛为中度强度和短持续时间。双侧颈浅丛阻滞(BSCPB)可能减少镇痛需求。然而,其在减少甲状腺切除术后疼痛的效果存在争议。

方法

本项在 100 例行甲状腺全切除术的患者中进行的双盲、随机安慰剂对照研究,评估了用 20mL0.75%罗哌卡因行 BSCPB 的效果。术后立即和 12 小时后给予额外的帕瑞昔布钠。

结果

术后疼痛采用视觉模拟评分量表评估。所有参数均在术后 0、3、6、9、12 和 24 小时记录。除 H12 时刻(p=0.76)外,对照组在所有时刻的数值均高于罗哌卡因组(p<0.05)。对照组中有 7 例(14%)患者需要额外镇痛,而罗哌卡因组中有 8 例(16%)患者需要(p=0.96)。

结论

两点双侧 BSCPB 对甲状腺全切除术后患者具有显著的镇痛作用,术后疼痛评分有统计学显著降低。然而,需要额外镇痛的患者比例无显著差异。

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