Babin R W, Panje W R
Laryngoscope. 1980 Aug;90(8 Pt 1):1321-3.
Pressure receptors exist within the walls of the carotid bulb which are responsible for maintaining the balance between blood volume, vascular tone, and cardiac output. When these receptors are manipulated during neck surgery the result may be bradycardia, hypotension or cardiac arrythmia. Such events occur sporatically during head and neck surgery and occasionally may prove fatal. While many surgeons advocate anesthetizing the carotid bulb prophylactically, this practice is not universally accepted. A retrospective appraisal of 76 radical neck dissections demonstrated an incidence of clear cut vasovagal reflex activity of 10%. Thirty-one radical neck procedures were then randomized into treatment and control groups in a prospective fashion. The treatment group (12 patients) had 5 cc. of 2% lidocaine applied topically to the carotid bifurcation. Nineteen controls had normal saline applied to the same site. The incidence of vasovagal reflexes in the control group was 10% and 16% in the treatment group. The similarity of these treatment groups is highly significant. It is concluded that topical 2% lidocaine is not an adequate prophylaxis for vasovagal reflexes during radical neck dissection.
压力感受器存在于颈动脉窦壁内，负责维持血容量、血管张力和心输出量之间的平衡。在颈部手术中对这些感受器进行操作时，结果可能是心动过缓、低血压或心律失常。此类事件在头颈外科手术中偶尔发生，有时可能是致命的。虽然许多外科医生主张预防性麻醉颈动脉窦，但这种做法并未得到普遍认可。对76例根治性颈清扫术的回顾性评估显示，明确的血管迷走反射活动发生率为10%。然后将31例根治性颈部手术以前瞻性方式随机分为治疗组和对照组。治疗组（12例患者）在颈动脉分叉处局部应用5毫升2%利多卡因。19例对照组在同一部位应用生理盐水。对照组血管迷走反射的发生率为10%，治疗组为16%。这些治疗组之间的相似性非常显著。得出的结论是，局部应用2%利多卡因对根治性颈清扫术中的血管迷走反射不是一种充分的预防措施。
