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超声引导下双侧颈浅丛阻滞与围手术期静脉输注利多卡因对甲状腺切除术后患者恢复质量的影响:一项随机双盲对照试验

Effect of ultrasound-guided bilateral superficial cervical plexus block versus perioperative intravenous lidocaine infusion on postoperative quality of recovery in patients undergoing thyroidectomy: A randomised double-blind comparative trial.

作者信息

Yang Xiaoqian, Yang Hui, Li Mengci, Zhu Kairun, Shen Lulu, Xie Chenglan

机构信息

Department of Anaesthesiology, Affiliated Huaian Hospital of Xuzhou Medical University, Jiangsu, China.

出版信息

Indian J Anaesth. 2024 Mar;68(3):238-245. doi: 10.4103/ija.ija_852_23. Epub 2024 Feb 22.

Abstract

BACKGROUND AND AIMS

Recent studies have found that ultrasound-guided (USG) bilateral superficial cervical plexus block (BSCPB) and intravenous infusion of lidocaine (IVL) have the potential to improve the quality of postoperative recovery. This study aimed to investigate and compare their effects on postoperative quality of recovery in patients undergoing thyroidectomy.

METHODS

A total of 135 patients were randomised to Group N: BSCPB with 10 mL 0.75% ropivacaine on each side, Group L: intravenous lidocaine (1.5 mg/kg for 10 min, followed by 1.5 mg/kg/h) and Group C: intravenous saline combined with BSCPB saline. The primary objective was quality of recovery-40 (QoR-40). Other parameters compared were numeric rating pain scale (NRS) score, haemodynamic data, opioid dosage and incidence of adverse effects. Statistical analysis was performed using the one-way analysis of variance (ANOVA), the Kruskal-Wallis test and the Chi-square test.

RESULTS

Compared to Group C, both groups N and L had higher QoR-40 total scores as well as scores indicating physical comfort, emotional state and pain dimensions on postoperative day (POD) 1 and POD2 ( < 0.001). The QoR-40 total and pain dimension scores in Group N were higher on POD1 and POD2 ( < 0.05). The NRS scores and the change in haemodynamics were lower in Group N compared to groups L and C ( < 0.05). The results of other parameters were lower in groups N and L than in Group C ( < 0.05).

CONCLUSION

USG BSCPB and IVL are comparable in improving the quality of postoperative recovery in patients undergoing thyroidectomy.

摘要

背景与目的

近期研究发现,超声引导下(USG)双侧颈浅丛阻滞(BSCPB)和静脉输注利多卡因(IVL)有可能改善术后恢复质量。本研究旨在调查并比较它们对甲状腺切除术患者术后恢复质量的影响。

方法

总共135例患者被随机分为N组:双侧各注射10 mL 0.75%罗哌卡因进行BSCPB;L组:静脉注射利多卡因(1.5 mg/kg,持续10分钟,随后以1.5 mg/kg/小时的速度输注);C组:静脉注射生理盐水并联合BSCPB注射生理盐水。主要观察指标为恢复质量-40(QoR-40)。比较的其他参数包括数字疼痛评分量表(NRS)评分、血流动力学数据、阿片类药物用量及不良反应发生率。采用单因素方差分析(ANOVA)、Kruskal-Wallis检验和卡方检验进行统计学分析。

结果

与C组相比,N组和L组在术后第1天(POD1)和第2天(POD2)的QoR-40总分以及表示身体舒适度、情绪状态和疼痛维度的得分均更高(P<0.001)。N组在POD1和POD2的QoR-40总分及疼痛维度得分更高(P<0.05)。与L组和C组相比,N组的NRS评分和血流动力学变化更低(P<0.05)。N组和L组其他参数的结果均低于C组(P<0.05)。

结论

在改善甲状腺切除术患者术后恢复质量方面,USG BSCPB和IVL效果相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce3f/10926339/63a7560b77eb/IJA-68-238-g001.jpg

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