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双侧颈浅丛阻滞对熵指数引导下全身麻醉甲状腺手术中七氟醚用量的影响:一项前瞻性随机研究。

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study.

作者信息

Kannan Sudheesh, Surhonne Nethra S, R Chethan Kumar, B Kavitha, D Devika Rani, R S Raghavendra Rao

机构信息

Department of Anesthesiology, Bangalore Medical College and Research Institute, Karnataka, India.

出版信息

Korean J Anesthesiol. 2018 Apr;71(2):141-148. doi: 10.4097/kjae.2018.71.2.141. Epub 2018 Apr 2.

Abstract

BACKGROUND

Bilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery.

METHODS

Fifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded.

RESULTS

Demographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B.

CONCLUSIONS

Preinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.

摘要

背景

双侧颈浅丛阻滞(BSCPB)可提供良好的术后镇痛效果,但其对麻醉药物用量的影响尚不清楚。本研究评估了BSCPB对甲状腺手术中七氟醚用量的影响。

方法

在这项前瞻性双盲研究中,50例患者被随机分为A组和B组,每组25例。A组在熵指数引导下全身麻醉前接受20 ml 0.25%布比卡因的BSCPB,而B组接受20 ml生理盐水。记录术中血流动力学参数、呼气末七氟醚浓度、最低肺泡有效浓度和七氟醚用量。使用视觉模拟评分法评估术后疼痛,并记录首次要求镇痛的时间。记录所有副作用。

结果

两组患者的人口统计学特征具有可比性。A组的平均七氟醚用量[30分钟时:A组=7.2(1.1)ml,B组=8.8(2.0)ml,P = 0.001;60分钟时:A组=13.5(1.7)ml,B组=16.5(3.9)ml,P = 0.002]和平均呼气末七氟醚浓度[30分钟时:A组=1.2%(0.2%),B组=1.4%(0.2%),P = 0.008;60分钟时:A组=1.2%(0.1%),B组=1.4%(0.2%),P = 0.010]均显著低于B组。与B组相比,A组患者的镇痛持续时间更长[361.6(79.5)分钟对151.0(60.2)分钟,P < 0.001]。

结论

甲状腺手术中诱导前进行BSCPB可显著降低七氟醚用量,并延长术后镇痛时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d581/5903117/20181211b443/kjae-2018-71-2-141f1.jpg

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