论文部分内容阅读
目的：观察右侧星状神经节阻滞（RSGB）联合表面麻醉对清醒气管插管患者心率变异性的影响。方法选择择期需经鼻气管插管患者21例，性别不限，年龄18~60岁，体质量指数（18~24）kg/ m2，ASA Ⅰ~Ⅱ级。每例患者采用清醒慢诱导法，在插管前行右侧星状神经节阻滞和环甲膜穿刺表面麻醉。观察阻滞前基础值（ T0）、气管插管前即刻（T1）、气管插管后即刻（T2）、气管插管后1 min（T3）、气管插管后3 min（T4）、气管插管后5 min（T5）的低频功率（LF）、高频功率（HF）、总频功率（TP）、LF/ HF 的比值，并计算 LF、HF 的标准化值（LFnu、HFnu），同时记录气管插管完成所需时间和不良反应。结果与 T0相比，T1、T4、T5各时点 LF 值显著降低（P ＜0.05或＜0.01），T1~ T5各时点 LFnu、HF、HFnu 及LF/ HF 值比较差异未见统计学意义（P ＞0.05）。结论右侧星状神经节阻滞联合表面麻醉可调节清醒气管插管引起的交感神经兴奋，维持交感和副交感神经张力平衡。“,”Objective To observe the effects of right stellate ganglion block(RSGB)combined with topical anesthesia on heart rate variability in patients with awake intubation. Methods Twenty-one ASA Ⅰ or Ⅱ patients aged 18 to 60 years old with body maindex(18 - 24)kg/ m2 underwent awake nasotracheal intubation anesthesia. RSGB and topical anesthesia through thyrocricocentesis were performed before nasotracheal intubation in each patient received slow induction. Low frequency power (LF),high frequency power(HF),total power(TP)and LF/ HF ratio were recorded before anesthesia(T0 ),before nasotracheal intubation immediately(T1 ),after nasotracheal intubation immediately(T2 ),1 min(T3 ),3 min(T4 )and 5 min(T5 )after naso-tracheal intubation. LF in normalized units(LFnu)and HF in normalized units(HFnu)were calculated. Besides,intubation du-ration and complications were recorded. Results Compared with the baseline values at T0 ,LF was significantly decreased at T1 and T5( P 0. 05 ). Conclusion RSGB combined with topical anesthesia can adjust awake intubation-induced sympathetic excitability and maintain the balance between sympathetic and parasympathetic tension.