Effects of cervical plexus block anesthesia combined with general anesthesia on subtotal thyroidectomy in patients with hyperthyroidism and stress response
10.3760/cma.j.cn231583-20220506-00150
- VernacularTitle:颈丛神经阻滞麻醉联合全身麻醉对甲状腺功能亢进症患者甲状腺次全切除术效果及应激反应影响
- Author:
Guoyun ZHONG
1
;
Min QIAN
;
Hanhui ZHOU
Author Information
1. 江苏省张家港市中医医院麻醉科，苏州 215600
- Keywords:
Hyperthyroidism;
Subtotal thyroidectomy;
Cervical plexus block anesthesia;
Effect;
Safety
- From:
Chinese Journal of Endemiology
2022;41(12):999-1003
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of cervical plexus block anesthesia combined with general anesthesia on subtotal thyroidectomy in patients with hyperthyroidism and stress response.Methods:A total of 68 patients with hyperthyroidism who underwent subtotal thyroidectomy in Zhangjiagang City Hospital of Traditional Chinese Medicine, Jiangsu Province, from January 2018 to January 2021 were selected as observation subjects, and were divided into control group and observation group according to the random number table method, both of which were 34 cases. Patients in control group were given general anesthesia, and the observation group was given cervical plexus block anesthesia combined with general anesthesia. The heart rate and mean arterial pressure before anesthesia (T0), immediately before intubation (T1), immediately after intubation (T2), and at the end of surgery (T3), the time of awakening and extubation after surgery, the visual analog score (VAS) of pain at 1, 4, 12, and 24 hours after surgery, stress response of before and 24 hours after surgery, and complications after surgery were compared between the two groups.Results:There was no significant difference in heart rate and mean arterial pressure between the two groups at T0 ( P > 0.05); the heart rate and mean arterial pressure at T1 were lower than those at T0 in the same group ( P < 0.05); the heart rate and mean arterial pressure at T2 and T3 in the control group were higher than those at T0 in the same group ( P < 0.05); the heart rate and mean arterial pressure at T2 and T3 in the observation group did not change significantly compared with those at T0 in the same group ( P > 0.05), but were lower than those in the control group at the same time ( P < 0.05). The awakening time and extubation time of patients in the observation group were shorter than those in the control group ( P < 0.001). The VAS scores of patients in the observation group were lower than those in the control group at 4, 12 and 24 hours after surgery ( P < 0.001). The serum norepinephrine (NE) and cortisol (COR) levels of patients in the two groups at 24 hours after surgery were higher than those before surgery, and the levels in the observation group were lower than those in the control group at the same time ( P < 0.05). The total incidence of postoperative complications in the observation group (8.82%, 3/34) was lower than that in the control group (29.41%, 10/34, χ 2 = 4.66, P = 0.031). Conclusion:Cervical plexus block anesthesia combined with general anesthesia has a good effect on subtotal thyroidectomy in patients with hyperthyroidism, which can speed up the patients' awakening, reduce complication, and has little impact on stress response.
