%0 Journal Article %T 星状神经节阻滞与全麻插管期心血管反应 %A 陈华梅 %A 廖琪 %J 华西医学 %P 66-68 %D 2011 %X 【】 目的 观察右星状神经节阻滞(R-SGB)对全身麻醉气管内插管期心血管反应的影响。 方法 2009年10-12月选取60例美国麻醉医师协会(ASA)Ⅰ、Ⅱ级择期全麻手术患者,随机分为3组。研究组于全麻诱导前15min用1%利多卡因10mL经颈6入路行R-SGB,对照组1诱导前同法注射10mL生理盐水,对照组2诱导前肌注2%利多卡因5mL。观察气管插管前后收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)、心率(HR)、心电图(ECG)、氧饱和度(SpO?2)和心率收缩压乘积(RPP)的变化。 结果 研究组各时点与进入手术室时的基础值比较,仅诱导后SBP、DBP、MBP显著降低,窥喉时HR和RPP显著升高(P<0.01);在插管3min后已恢复至基础值。对照组1和对照组2诱导后SBP、DBP、MBP显著降低(P<0.01);窥喉时SBP、DBP、MBP、HR、RPP均显著升高(P<0.01),并持续至插管后5min。两对照组升高的程度均显著高于研究组(P<0.05或P<0.01)。 结论 R-SGB对全麻气管插管期的心血管反应有一定抑制作用,可用于调控全麻插管期心血管不良反应。?【Abstract】 Objective Toexploretheeffectofrightstellateganglionblock(R-SGB)oncardiovascularresponseduringendotrachealintubationunderthegeneralanesthesia. Methods SixtyASAⅠ-ⅡpatientswhounderwentgeneralanaesthesiabetweenOctobertoDecember2009wererandomlydividedintothreegroups.ThepatientsinthetrialgroupacceptedR-SGBbyC6routewith1%lidocaine(10mL)15minutesbeforeinductionofgeneralanesthesia;thepatientsincontrolgroup1wereinjectedwith10mLphysiologicalsalineinthesamewaybeforetheinduction;thepatientsincontrolgroup2underwenttheintramuscularinjectionof2%lidocaine(5mL)beforetheinduction.Thechangesofsystolicbloodpressure(SBP),diastolicbloodpressure(DBP),meanarterialpressure(MAP),hearrate(HR),electrocardiogram(ECG),oxygensaturation(SpO?2)andheartrate-systolicbloodpressureproduct(RPP)beforeandafterendotrachealintubationwereobservedandrecorded. Results Inthetrialgroup,SBP,MAP,andDBPdecreasedsignificantlyaftertheinduction;HRandRPPincreasedevidentlyatthelaryngealexposurecomparedwiththebaselinevalues(P<0.01)andrecoveredthreeminutesaftertheintubation.Inthecontrolgroup1and2,SBP,MAP,andDBPdecreasedsignificantlyafterinduction(P<0.01);SBP,MAP,DBP,HRandRPPincreasedapparentlyatthelaryngealexposurecomparedwiththebaselinevalues(P<0.01),andtheraisecontinueduntilfiveminutesafterendotrachealintubation.Thedifferenceintheraisebetweenthecontrolgroupsandthetrialgroupwassignificant(P<0.05orP<0.01). Conclusion R-SGBmayeffectivelyinhibitthecardiovascularresponseduringendotrachealintubationunderthegeneralanesthesiaandcanbeusedtocontrolthenegativereactionduringtheinduction. %K 星状神经节阻滞 %K 气管插管 %K 心血管反应 %K 应激 %U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201101020