超声引导下星状神经节阻滞对头面部手术术后疼痛、免疫及抗氧化能力的影响

方懿; 刘松华; 李琼灿

doi:10.13898/j.cnki.issn.1000-2200.2020.10.025

超声引导下星状神经节阻滞对头面部手术术后疼痛、免疫及抗氧化能力的影响

Effect of stellate ganglion block guided by ultrasound on the pain, immunity and antioxidant capacity after head and face surgery

摘要

摘要:
目的探讨超声引导下星状神经节阻滞对头面部手术术后疼痛、免疫及抗氧化能力的影响。
方法选择头面部手术病人80例，按照随机数字表法分为2组，各40例。观察组在麻醉诱导前行超声引导下右侧星状神经节阻滞，对照组则实施常规全身麻醉，比较2组病人术后不同时间疼痛数字评分变化，分析2组术后自主进食时间、下床活动时间、术后住院时间，比较术后48 h 2组免疫功能和抗氧化能力及并发症。
结果2组术后不同时间疼痛数字评分变化差异有统计学意义（P < 0.01）；2组不同时间点疼痛数字评分均降低，且观察组疼痛数字评分低于对照组（P < 0.01）；随时间变化，2组疼痛评分均呈降低趋势（P < 0.01）；观察组术后自主进食时间、下床活动时间均早于对照组，术后住院时间短于对照组（P < 0.01）；观察组术后48 h免疫指标IgA和IgG水平、SOD水平高于对照组，抗氧化能力指标MDA水平低于对照组（P < 0.01）；观察组术中心动过速、麻醉苏醒延迟、术后出血及术后感染的总发生率低于对照组（P < 0.01）。
结论针对头面部手术病人，实施超声引导下右侧星状神经节阻滞，能有效缓解病人术后疼痛，提高机体免疫力及抗氧化能力，减少并发症。

Abstract:
ObjectiveTo investigate the effects of stellate ganglion block guided by ultrasound on pain, immunity and antioxidant capacity after head and face surgery.
MethodsEighty patients treated with craniofacial surgery were randomly divided into the observation group and control group(40 cases each group).The observation group was treated with right stellate ganglion block guided by ultrasound before anesthesia induction, while the control group was treated routine general anesthesia.The changes of pain digital scores at different times after operation were compared between two groups.The time of self-eating, getting out of bed and hospitalization in two groups after operation were analyzed, and the immune function, antioxidant ability and complications 48 h after operation were compared between two groups.
ResultsThe differences of the pain digital score between two groups at different times were statistically significant after operation(P < 0.01).The pain digital scores in two groups at different time-points decreased, and which in observation group was lower than that in control group(P < 0.01).The pain scores in two groups showed a decreasing trend with time going on(P < 0.01).The time of postoperative self-eating and getting out of bed in observation group were earlier than those in control group, and the time of hospitalization after operation was shorter than that in control group(P < 0.01).The levels of IgA, IgG and SOD in observation group were higher than those in control group after 48 h of operation, and the level of MDA of antioxidant capacity index in observation group was lower than that in control group(P < 0.01).The total incidence rate of tachycardia, anesthesia recovery delay, postoperative hemorrhage and postoperative infection in observation group was lower than that in control group(P < 0.01).
ConclusionFor patients treated with head and face surgery, the right stellate ganglion block guided by ultrasound can effectively relieve the postoperative pain, improve the body immunity and antioxidant capacity, and reduce complications.

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