超声引导下颈部迷走神经阻滞预防眼心反射的临床研究

张琦玮; 李洪超; 宁林; 毛庆祥; 闫红

doi:10.11659/jjssx.02E024017

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超声引导下颈部迷走神经阻滞预防眼心反射的临床研究

临床研究 | 更新时间：2024-09-29

- 超声引导下颈部迷走神经阻滞预防眼心反射的临床研究
- Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex
- 局解手术学杂志 2024年33卷第9期页码：815-819
- 作者机构：
  
  陆军军医大学大坪医院麻醉科，重庆 400042
- 作者简介：
  
  闫红，E-mail：cqyanhong@163.com
- 基金信息：
  
  重庆市自然科学基金项目(cstc2019jcyj-msxmX0018)
- DOI：10.11659/jjssx.02E024017
  中图分类号： R614.2
- 纸质出版日期：2024-09-25，
  
  收稿日期：2024-02-05，
- 稿件说明：
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张琦玮,李洪超,宁林等.超声引导下颈部迷走神经阻滞预防眼心反射的临床研究[J].局解手术学杂志,2024,33(09):815-819.

ZHANG Qi-wei,LI Hong-chao,NING Lin,et al.Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):815-819.
张琦玮,李洪超,宁林等.超声引导下颈部迷走神经阻滞预防眼心反射的临床研究[J].局解手术学杂志,2024,33(09):815-819. DOI： 10.11659/jjssx.02E024017.

ZHANG Qi-wei,LI Hong-chao,NING Lin,et al.Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):815-819. DOI： 10.11659/jjssx.02E024017.

摘要

目的

观察超声引导下颈部迷走神经阻滞（CVB）对眼心反射的预防效果。

方法

招募行巩膜后兜带术或眼球摘除术的患者86例，随机分为全麻组和复合麻醉组。2组患者入室后均进行常规全身麻醉诱导插管，复合麻醉组另采用1%利多卡因在超声引导下行右侧CVB。记录2组患者术中心率、血压、血氧饱和度、阿托品使用情况和手术操作情况；比较2组患者术后舒适度、声音嘶哑及神经阻滞相关并发症发生情况。

结果

与全麻组比较，复合麻醉组患者使用阿托品占比、暂停手术操作占比明显降低(

0.05)，眼心反射发生率、眼心反射发生级别明显降低(

0.05)；复合麻醉组患者声音嘶哑发生率高于全麻组，差异有统计学意义(

0.05)；复合麻醉组患者未发生神经阻滞相关并发症。

结论

超声引导下右侧CVB用于眼科手术能安全有效地抑制眼心反射的发生。

Abstract

Objective

To observe the preventive effect of ultrasound-guided cervical vagus nerve block（CVB） in preventing oculocardiac reflex.

Methods

A total of 86 patients who underwent posterior scleral reinforcement or ophthalmectomy were recruited and randomly divided into the general anesthesia group and the composite anesthesia group.After admission， patients in the two groups underwent conventional general anesthesia induction intubation， and the composite anesthesia group received another 1% lidocaine for right CVB under ultrasound guidance.The heart rate， blood pressure， saturation of peripheral oxygen， atropine usage and surgical procedures of the two groups were recorded. Postoperative comfort degree， hoarseness and complications related to nerve block were compared between the two groups.

Results

Compared with the general anesthesia group， the proportion of patients using atropine and the proportion of suspending operation in the composite anesthesia group were significantly reduced （

0.05），and the incidence of oculocardiac reflex and the level of oculocardiac reflex were significantly decreased （

0.05）.The incidence of hoarseness in the composite anesthesia group was higher than that in the general anesthesia group， and the difference was statistically significant （

0.05）. There was no complication related to nerve block occurred in the composite anesthesia group.

Conclusion

In ophthalmic surgery，ultrasound-guided right CVB can safely and effectively inhibit the occurrence of oculocardiac reflex.

关键词

超声引导迷走神经阻滞眼心反射并发症

Keywords

ultrasound guidancecervical vagus nerve blockoculocardiac reflexcomplication

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