|
|
Influence of superficial cervical plexus block on the quality of resuscitation and inflammatory response in patients undergoing general anesthesia for thyroid surgery |
WU Hong-hui1ZHENG Man1TIAN Wei-qian1JIANG Hui-li1CUI Yao-mei1YANG Guang1,2▲ |
1.Department of Anesthesiology,the Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210029,China; 2.Jiangsu Province Key Laboratory of Anesthesiology,Xuzhou Medical University,Jiangsu Province,Xuzhou 221004,China |
|
|
Abstract Objective To investigate the influence of superficial cervical plexus block(SCPB)on the resuscitation quality and inflammatory response of patients undergoing thyroid surgery under general anesthesia.Methods A total of 201 patients requiring thyroid surgery in Affiliated Hospital of Nanjing University of Chinese Medicine from March to November 2020 were retrospectively selected as the study subjects.According to whether bilateral ultrasound-guided SCPB was performed,the patients were divided into SCPB group (82 cases)and non-SCPB group (119 cases).Operation time,intraoperative blood loss,serum interleukin-6(IL-6),tumor necrosis factor-α (TNF-α)and interleukin-1 β(IL-1β)levels,intraoperative dosage of propofol,sufentanil and remifentanil,recovery time of spontaneous breathing of patients in anesthesia recovery room (PACU),time of tracheal tube removal and PACU retention time,visual analogue scale(VAS)score and condition of post operative nausea and vomitting(PONV)at 24 h postoperatively were compared between the two groups.Results There were no significant differences in operative time and intraoperative blood loss between the two groups(P>0.05).The intraoperative dosage of propofol,sufentanil and remifentanil in SCPB group was lower than that in non-SCPB group,the difference was statistically significant(P<0.05).The recovery time of spontaneous breathing and the time of tracheal tube removal were earlier in SCPB group than in non-SCPB group,and the PACU residence time was shorter in SCPB group than in non-SCPB group,the differences were statistically significant(P<0.05).The levels of IL-1β,IL-6 and TNF-α in SCPB group were lower than those in non-SCPB group,the differences were statistically significant(P<0.05).24 h after surgery,VAS score and PONV incidence in SCPB group were lower than those in non-SCPB group,the differences were statistically significant(P<0.05).Conclusions Ultrasound-guided bilateral superficial cervical plexus block could improve the quality of resuscitation in patients undergoing general anesthesia for thyroid surgery.The consumptions of intraoperative anesthetics were reduced,the postoperative pain and PONV during the firsr postoperative 24 h were reduced,and postoperative inflammatory reactions were reduced.
|
|
|
|
|
[3] |
Myles PS.Measuring quality of recovery in perioperative clinical trials[J].Curr Opin Anaesthesiol,2018,31(4):396-401.
|
[6] |
邓小娥,张丽凤,周春锋,等.早期拔除气管导管对肺癌患者全麻苏醒期复苏质量的影响[J].四川医学,2021,42(5):433-437.
|
[1] |
Jakob DA,Riss P,Scheuba C,et al.Association of surgical volume and quality management in thyroid surgery:a twonation multicenter study[J].World J Surg,2019,43(9):2218-2227.
|
[2] |
Borrell-Vega J,Humeidan ML,Bergese SD.Defining quality of recovery-What is important to patients?[J].Best Pract Res Clin Anaesthesiol,2018,32(3-4):259-268.
|
[4] |
Senapathi TGA,Widnyana IMG,Aribawa IGNM,et al.Ultrasound-guided bilateral superficial cervical plexus block is more effective than landmark technique for reducing pain from thyroidectomy[J].J Pain Res,2017,10:1619-1622.
|
[5] |
Mayhew D,Sahgal N,Khirwadkar R,et al.Analgesic efficacy of bilateral superficial cervical plexus block for thyroid surgery:meta-analysis and systematic review[J].Br J Anaesth,2018,120(2):241-251.
|
[7] |
Tran DQH,Dugani S,Finlayson RJ.A randomized comparison between ultrasound-guided and landmark-based superficial cervical plexus block[J].Reg Anesth Pain Med,2010,35(6):539-543.
|
[8] |
Kale S,Aggarwal S,Shastri V.Evaluation of the analgesic effect of bilateral superficial cervical plexus block for thyroid surgery:a comparison of presurgical with postsurgical block[J].Indian J Surg,2015,77(3):1196-1200.
|
[9] |
Woolf CJ,Chong MS.Preemptive analgesia—treating postoperative pain by preventing the establishment of central sensitization[J].Anesth Analg,1993,77(2):362-379.
|
[10] |
Gürkan Y,Tas Z,Toker K,et al.Ultrasound guided bilateral cervical plexus block reduces postoperative opioid consumption following thyroid surgery[J].J Clin Monit Comput,2015,29(5):579-584.
|
[11] |
沈杰,季永.序贯式多模式镇痛在甲状腺癌功能性颈部淋巴结清扫术加速康复中的应用[J].临床与病理杂志,2021,41(2):28490-28290.
|
[12] |
Yao Y,Lin C,He Q,et al.Ultrasound-guided bilateral superficial cervical plexus blocks enhance the quality of recovery in patients undergoing thyroid cancer surgery:A randomized controlled trial[J].J Clin Anesth,2020,61:109651.
|
[13] |
Macario A,Weinger M,Carney S,et al.Which clinical anesthesia outcomes are important to avoid The perspective of patients[J].Anesth Analg,1999,89(3):652.
|
[14] |
Sui C,Liang N,Du R,et al.Time trend analysis of thyroid cancer surgery in China:single institutional database analysis of 15,000 patients[J].Endocrine,2020,68(3):617-628.
|
[15] |
Stadler M,Bardiau F,Seidel L,et al.Difference in risk factors for postoperative nausea and vomiting[J].Anesthesiology,2003,98(1):46-52.
|
[16] |
Suh YJ,Kim YS,In JH,et al.Comparison of analgesic efficacy between bilateral superficial and combined(superficial and deep)cervical plexus block administered before thyroid surgery[J].Eur J Anaesthesiol,2009,26(12):1043-1047.
|
[17] |
王敬,朱敏敏,朱赟,等.氟比洛芬酯联合颈丛神经阻滞用于甲状腺癌联合根治术的超前镇痛[J].中国癌症杂志,2010,20(2):151-155.
|
[18] |
Turabelidze A,Dipietro LA.Inflammation and wound healing[J].Endodontic Topics,2011,24(1):26-38.
|
|
|
|