摘要
目的评价超声引导星状神经节阻滞(SGB)在老年冠心病患者腹腔镜胆囊切除术中的效果。方法选择择期行腹腔镜胆囊切除术且合并老年冠心病的患者50例,随机分为两组,每组25例,SGB组于麻醉诱导前行右侧SGB,对照组在同一位置注射等量生理盐水,之后两组患者均接受常规全身麻醉。记录患者全身麻醉前(T0)、气管插管即刻(T1)、手术切皮即刻(T2)、术毕(T3)以及术后6 h(T4)的平均动脉压(MAP)和心率(HR);检测患者各时间点的血浆肾上腺素(E)、去甲肾上腺素(NE)和B型尿钠肽(BNP)浓度;记录两组患者穿刺部位血肿、感染、恶心、呕吐、胸闷、呼吸抑制等不良事件的发生情况。结果两组患者的人口学资料及术前MAP、HR及血浆E、NE、BNP浓度差别均无统计学意义(P>0.05)。SGB组于T1-T4各时间点的MAP和HR以及血浆E和NE的浓度均低于对照组,差别有统计学意义(P<0.05);两组患者各时间点的血浆BNP浓度和不良事件发生率差别均无统计学意义(P>0.05)。结论SGB有助于控制应激,维持患者血流动力学稳定,用于老年冠心病患者腹腔镜胆囊切除术是安全有效的。
Objective To investigate the effect of ultrasoundguided stellate ganglion block(SGB)in aged patients with coronary heart disease(CHD)undergoing laparoscopic cholecystectomy(LC).Methods Fifty aged patients with CHD scheduled for selective LC under general anesthesia were enrolled.Patients were randomly assigned to 2 groups receiving ultrasoundguided SGB(SGB group,n=25)or saline control(control group,n=25)before the induction of general anesthesia.Mean arterial pressure(MAP)and heart rate(HR)were monitored before receiving general anesthesia(T 0),intubation(T 1),skin incision(T 2),the end of surgery(T 3),and 6 h after surgery(T 4).Serum concentration of epinephrine(E),norepinephrine(NE),and brain natriuretic peptide(BNP)were detected at each given time point.Adverse events including hematomas,nausea,vomiting,chest distress,and respiratory depression were recorded.Results There was no statistical difference on demographic information,baseline MAP and HR,as well as serum concentration of E,NE and BNP between two groups(P>0.05).Compared with control group,both of MAP and HR,as well as serum concentration of E and NE in SGB group were significantly lower at T 1 T 4 time points(P<0.05).There was no significant difference on serum concentration of BNP,as well as the incidence of adverse events between two groupsobserved(P>0.05).Conclusion SGB is beneficial for controlling perioperative stress and keeping the hemodynamic stable,and it can be safely used in aged patients with CHD undergoing LC.
作者
陈鹭
梁敏
郑如洁
吴海玲
林财珠
CHEN Lu;LIANG Min;ZHENG Rujie;WU Hailing;LIN Caizhu(Department of Anesthesiology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)
出处
《福建医科大学学报》
2019年第4期267-271,共5页
Journal of Fujian Medical University
基金
福建医科大学苗圃基金(2015MP028)
