电针在甲状腺次全切除术中对脑电双频指数的影响

作者	单位
刘育勇	暨南大学附属第一医院麻醉科 (广州510630)
李雅兰	暨南大学附属第一医院麻醉科 (广州510630)
蔡明雪	暨南大学附属第一医院麻醉科 (广州510630)
邹鹏	暨南大学附属第一医院麻醉科 (广州510630)
来勇	暨南大学附属第一医院麻醉科 (广州510630)
胡冬华	暨南大学附属第一医院麻醉科 (广州510630)

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中文摘要:

目的研究电针刺激在甲状腺次全切除术中对脑电双频指数的影响。方法选择60例行双侧甲状腺次全切除术患者,随机分为观察组(针刺加颈丛阻滞组30例)和对照组(颈丛阻滞组30例)。观察组于双侧“合谷”、“内关”穴针刺有“得气”感后接上电刺激仪连续高频密波刺激,5min之后行双侧颈丛阻滞;对照组单行颈丛阻滞,方法同观察组。围术期连续监测平均动脉压(MAP)、心率(HR)、动脉血氧饱和度(SaO2)、脑电双频指数(BIS)。记录患者术中疼痛强度评分(visualanalogscale,VAS)和镇静与紧张程度评分(verbalstressscale,VSS),并记录围术期并发症和不良反应。结果对照组术中MAP明显升高,明显高于观察组(P<0.01);两组HR都明显加快,但对照组明显高于观察组(P<0.01)。观察组术中BIS明显降低,与对照组比较差异有显著性(P<0.01)。观察组与对照组术中追加芬太尼〔分别为(59.5±15.5)μg、(106.7±37.1)μg〕和利多卡因的剂量〔分别为(23.8±22.7)mg、(62.7±38.2)mg〕,观察组均明显少于对照组(P<0.01);术中VAS和VSS评分,观察组均明显低于对照组(P<0.01)。结论电针刺激可加强颈丛阻滞在甲状腺次全术中的麻醉效果,明显降低BIS值。

英文摘要:

ObjectiveTo investigate the effects of electroacupuncture on bispectral index(BIS)of electroencephalography in patients undergoing subtotal thyroidectomy.Methods Sixty patients were equally randomized into group A given electroacupuncture combined with cervical plexus block(CPB)and group B given CPB alone.After needling sensation was reached in bilateral “Hegu" and “Neiguan" acupoints,5 min of high frequency electrical stimulation by electrical stimulation device followed with CPB was applied to group A,while only CPB was performed in group B.Visual analog scale(VAS)and verbal stress scale(VSS)were monitored,complication and adverse reaction were observed and BIS,mean arterial pressure(MAP),heart rate(HR)and arterial oxygen saturation(SaO2)were monitored continuously in the perioperative period.Results HR increased and BIS decreased in group A,both were lower significantly than those in group B(P<0.01);MAP,the complementary dosage of fentanyl and lidocaine used and scores of VAS and VSS were also lower in group A than those in group B(P<0.01).Conclusion Electroacupuncture could enhance the anesthetic effect of CPB,lower the BIS value during subtotal thyroidectomy.

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