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    陈光洪, 李俊青, 赵圆圆, 李腾飞, 席文凤, 袁浩. 超声引导星状神经节阻滞对膝关节置换术止血带反应的影响[J]. 蚌埠医科大学学报, 2021, 46(1): 54-57. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.015
    引用本文: 陈光洪, 李俊青, 赵圆圆, 李腾飞, 席文凤, 袁浩. 超声引导星状神经节阻滞对膝关节置换术止血带反应的影响[J]. 蚌埠医科大学学报, 2021, 46(1): 54-57. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.015
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    CHEN Guang-hong, LI Jun-qing, ZHAO Yuan-yuan, LI Teng-fei, XI Wen-feng, Yuan Hao. Effect of stellate ganglion block-guided by ultrasound on tourniquet response in knee arthroplasty[J]. Journal of Bengbu Medical University, 2021, 46(1): 54-57. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.015
    Citation: CHEN Guang-hong, LI Jun-qing, ZHAO Yuan-yuan, LI Teng-fei, XI Wen-feng, Yuan Hao. Effect of stellate ganglion block-guided by ultrasound on tourniquet response in knee arthroplasty[J]. Journal of Bengbu Medical University, 2021, 46(1): 54-57. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.015
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    超声引导星状神经节阻滞对膝关节置换术止血带反应的影响

    Effect of stellate ganglion block-guided by ultrasound on tourniquet response in knee arthroplasty

      摘要
    • 摘要:
      目的研究超声引导星状神经节阻滞(SGB)对膝关节置换术止血带反应的影响。
      方法选择行单侧膝关节置换术病人60例，用随机数字表法均分为2组，C组采取全身麻醉，E组采取超声引导下SGB联合全身麻醉。比较2组止血带充气前(T0)、止血带充气后30 min(T1)、止血带充气1 h(T2)、止血带放气前(T3)、止血带放气5 min(T4)、止血带放气30 min(T5)的心率(HR)、收缩压(SBP)、血氧饱和度(SpO2)、脑电双频指数(BIS)，并分析病人的麻醉药物用量(舒芬太尼)、清醒时间、拔管时间、术后睡眠质量，术后并发症。
      结果2组T0、T1、T2、T5的HR、SBP、SpO2、BIS比较，2组T4的HR、SpO2、BIS比较，2组T3的SpO2比较，差异均无统计学意义(P>0.05)；C组T3的HR、SBP、BIS高于E组(P < 0.05~P < 0.01)。C组的麻醉药物用量、清醒时间、拔管时间、术后睡眠质量评分显著高于E组(P < 0.05)；2组术中出血量、手术时间比较，差异均无统计学意义(P>0.05)。C组术后并发症发生率10.00%与E组术后并发症发生率6.67%比较，差异无统计学意义(P>0.05)。
      结论超声引导下SGB可降低膝关节置换术止血带反应，从而稳定病人的血流动力学，减少术中麻醉性镇痛药物的使用，不增加不良反应。

       

      Abstract:
      ObjectiveTo study the effects of ultrasound-guided stellate ganglion block(SGB)on tourniquet response in knee arthroplasty.
      MethodsSixty patients treated with unilateral knee arthroplasty were randomly divided into the group C and group E by random number table method.The group C and group E were treated with general anesthesia and SGB guided by ultrasound combined with general anesthesia.The heart rate(HR), systolic blood pressure(SBP), blood oxygen saturation(SpO2), EEG dual frequency index(BIS), anesthetic dosage, intraoperative blood loss, operation time, awake time, extubation time, postoperative sleep quality and postoperative complications were compared between two groups before tourniquet inflation(T0), after 30 min(T1)and 1 h(T2)of tourniquet inflation, before tourniquet deflation(T3), after 5 min(T4)and 30 min(T5)of tourniquet.
      ResultsThe differences of the HR, SBP, SpO2 and BIS at T0, T1, T2 and T5, the HR, SpO2 and BIS at T4, and the SpO2 at T3 were not statistically significant between two groups(P>0.05).The HR, SBP and BIS in C group at T3 were significantly higher than those in group E(P < 0.05 to P < 0.01).The anesthetic dosage, wake-up time, extubation time and postoperative sleep quality score in group C were significantly higher than those in group E(P < 0.05), and the differences of the intraoperative blood loss and operation time between two groups were not statistically significant(P < 0.05).The incidence rates of postoperative complication in group C and group E were 10.00% and 6.67, respectively, and the difference of which was not statistically significant(P>0.05).
      ConclusionsThe SGB guided by ultrasound can reduce the tourniquet response in knee replacement surgery, thereby stabilizing the patient's hemodynamics, reducing the use of intraoperative narcotic analgesics, and not increasing adverse reactions.

       

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