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目的比较右美托咪定、咪达唑仑联合颈丛神经阻滞在甲状腺切除手术中的镇静效果。方法甲状腺手术患者40例,随机分为右美托咪定组(Ⅰ组,20例)和咪达唑仑组(Ⅱ组,20例)。Ⅰ组神经阻滞5min后立即给予右美托咪定,Ⅱ组神经阻滞5min后给予咪达唑仑。观察各组患者神经阻滞前、阻滞后5min、切皮时、甲状腺分离时、手术结束时患者收缩压(SBP)、舒张压(DBP)、心率(HR)。结果与Ⅱ组比较,Ⅰ组患者在分离甲状腺时和手术结束时SBP、DBP、HR值明显降低,P<0.05;患者术中镇静、镇痛更完善,未发生上呼吸道梗阻和呼吸抑制。结论右美托咪定辅助颈丛神经阻滞用于甲状腺手术可以有效的抑制颈丛麻醉下的心血管反应,具有更好的镇静镇痛作用,可以使患者更配合,安全性更高。
Objective To compare the sedative effects of dexmedetomidine, midazolam combined with cervical plexus block in thyroidectomy. Methods Thirty patients with thyroid surgery were randomly divided into dexmedetomidine group (n = 20) and midazolam group (n = 20). Group Ⅰ dexmedetomidine immediately after 5min, group Ⅱ nerve block 5min after midazolam. The SBP, DBP and HR of the patients in each group were observed before nerve block, 5 minutes after block, skin incision, thyroid separation and the end of surgery. Results Compared with group Ⅱ, the SBP, DBP and HR of group Ⅰ were significantly lower at the time of thyroid separation and at the end of surgery (P <0.05). The patients were sedated and had better analgesia during operation. No upper airway obstruction and respiratory depression occurred. Conclusion Dexmedetomidine assisted cervical plexus block for thyroid surgery can effectively inhibit cardiovascular responses under cervical plexus anesthesia, with better sedative and analgesic effects, can make patients more compatible and safer.