摘要
目的比较静脉全麻与头部神经阻滞复合静脉全麻用于去骨瓣减压术的效果。方法急诊行去骨瓣减压术的脑损伤患者114例,性别不限,年龄44~69岁,BMI 21~25 kg/m^(2),ASAⅡ~Ⅲ级。采用随机数字表法分为头部神经阻滞复合静脉全麻组(观察组)和静脉全麻组(对照组),各57例。根据视觉模拟评分法(VAS)分别于术后3 h、6 h、12 h、24 h评价患者的疼痛程度。记录手术前后患者的MAP、HR血流动力学指标水平,检测患者的NSE、S100B脑功能指标。结果观察组患者术后3 h、6 h、12 h、24 h的VAS评分均低于对照组,差异有统计学意义(P<0.05)。术前2组患者的MAP、HR和NSE、S100B水平差异均无统计学意义(P>0.05)。术后2组患者的上述指标均高于术前,其中观察组均低于对照组,差异均有统计学意义(P<0.05)。结论头部神经阻滞复合静脉全麻用于去骨瓣减压术,镇痛效果优于静脉全麻,有利于维持患者血流动力学水平稳定和脑功能的改善。
Objective To compare the effects of intravenous anesthesia and scalp nerve block combined with intravenous anesthesia in decompressive craniectomy.Methods Totally 114 patients with brain injury underwent emergency decompressive craniectomy,regardless of gender,aged 44-69 years,BMI 21-25 kg/m^(2),ASAⅡ-Ⅲgrade.They were randomly divided into scalp nerve block combined with intravenous anesthesia group(observation group)and intravenous anesthesia group(control group),with 57 cases in each group.According to visual analogue scale(VAS),the pain degree of patients was evaluated at 3h,6h,12h and 24h after operation.The levels of MAP and HR hemodynamic indexes were recorded before and after the operation,and NSE and S100B brain function indexes were detected.Results The VAS scores of patients in the observation group at 3 h,6 h,12 h and 24 h after operation were lower than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in MAP,HR,NSE and S100B levels between the two groups before operation(P>0.05).After operation,the above indexes of patients in both groups were better than those before operation,and the observation group was better than that of the control group.The differences were statistically significant(P<0.05).Conclusion Scalp nerve block combined with intravenous anesthesia is used in decompressive craniectomy.The analgesic effect is better than that of intravenous anesthesia,which is conducive to maintaining the stability of hemodynamics and improving brain function.
作者
张杨
凤旭东
刘慧
孔二亮
魏海利
方玉花
Zhang Yang;Feng Xudong;Liu Hui;Kong Erliang;Wei Haili;Fang Yuhua(Department of Anesthesiology,the 988 Hospital of joint logistics support force,Zhengzhou 450000,China)
出处
《河南外科学杂志》
2022年第3期15-17,共3页
Henan Journal of Surgery
基金
河南省卫生健康委员会联合共建项目(LHGJ20210815)。
关键词
头部神经阻滞
静脉全麻
去骨瓣减压术
Scalp nerve block
Intravenous anesthesia
Decompressive craniectomy
