Influence of ultrasound-guided internal branch block of superior laryngeal nerve on stress response after uvula palatopharyngoplasty
10.3760/cma.j.cn431274-20240722-01129
- VernacularTitle:超声引导下喉上神经内支阻滞对悬雍垂腭咽成形术后患者应激反应的影响
- Author:
Xiaoling HUANG
1
;
Xuanxuan PENG
1
;
Yixun TANG
1
;
Huijuan DING
1
Author Information
1. 湖南省人民医院（湖南师范大学附属第一医院）麻醉科，长沙 410005
- Publication Type:Journal Article
- Keywords:
Sleep apnea, obstructive;
Uvulopalatopharyngoplasty;
Nerve block;
Superior laryngeal nerves
- From:
Journal of Chinese Physician
2025;27(3):397-401
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of ultrasound-guided internal branch block of superior laryngeal nerve on stress response during endotracheal catheter indwelling in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods:A total of 80 patients with severe obstructive sleep apnea syndrome requiring elective UPPP from the Hunan Provincial People′s Hospital from January 2020 to December 2021 were retrospectively selected and divided into nerve block group (group B) and dexmedetomidine group (group D). Patients in group B and D received general anesthesia. Patients in the group B received bilateral internal branch block of superior laryngeal nerve under ultrasound guidance before postoperative recovery. Patients in the group D received dexmedetomidine intravenously before the end of surgery. The cough scores and mean arterial pressure (MAP), heart rate (HR), plasma epinephrine (E) and norepinephrine (NE) levels of patients before anesthesia (T 1), immediately after recovery (T 2), 2 h after recovery (T 3), 6 h (T 4), and 12 h (T 5) during endotracheal catheterization were recorded in both groups. The Visual Analogue Scale (VAS) scores of T 2, T 3, T 4, T 5 and 24 h after surgery (T 6) were also obtained. Results:Compared with group D, the cough scores of the group B patients were significantly lower, and the number of cases requiring remedial analgesia was significantly less (all P<0.01). Compared with T 1, MAP and HR at T 2-T 5 time points in the group B and HR and MAP at T 2-T 5 time points in the group D were significantly increased (all P<0.05). Compared with the group D, MAP and HR were significantly higher than those at each time point of T 2-T 5 in the group B (all P<0.05). Compared with T 1, the serum NE and E levels in the group D at T 2-T 5 time points, and the serum NE and T 2 E levels in the group B at T 2-T 5 time points were increased, and the differences were statistically significant (all P<0.05). Compared with the group D, serum E and serum NE levels at T 2-T 5 and T 2-T 4 in the group B were significantly lower (all P<0.05). Compared with T 2, T 5-T 6 VAS scores in the group B and T 3-T 6 VAS scores in the group D were significantly decreased (all P<0.05). Compared with the group D, the VAS scores at T 2-T 5 time points in the group B were significantly lower (all P<0.05). Conclusions:Compared with intravenous use of dexmedetomidine, ultrasound-guided internal branch block of superior laryngeal nerve can significantly reduce the discomfort and stress response during catheterization after UPPP, increase the comfort level of patients, reduce the incidence of postoperative complications, and promote rapid recovery of patients.
