中国医学科学院学报2017，Vol.39Issue(5)：688-692,5.DOI:10.3881/j.issn.1000-503X.2017.05.015
超声引导下C4神经根加颈浅丛阻滞在微创甲状旁腺手术中的应用
Ultrasound-guided Selective Cervical Nerve Root Block Plus Superficial Cervical Plexus Block for Minimally Invasive Parathyroidectomy
摘要
Abstract
Objective To explore the efficacy and safety of ultrasound-guided cervical root block (CRB) in patients undergoing minimally invasive parathyroidectomy (MIP).Methods We enrolled 35 patients with hyperparathyroidism undergoing MIP in Peking Union Medical College Hospital.C4-7 nerve roots were identified in ultrasound imaging by the shape of the transverse process.A 50 mm insulated needle was gently introduced by an in-plane approach toward the posterior edge of the nerve root located at the inside of the posterior tubercle.After careful aspiration,a total of 3-4 ml of a mixture of 0.5 ％ ropivacaine and 1％ lidocaine was slowly injected.The superficial block was administered at the midpoint of the posterior border of the sternocleidomastoid by injecting 5-6 ml of the same mixture.The patients were administrated with dexmedetomidine during the surgery.All patients were assessed for sensory following the procedure and for pain after the surgery.Results Totally 35 patients successfully received MIP under ultrasound-guided CRB plus superficial block.There was no conversion to general anesthesia,no toxic reaction of local anesthetics,and no intravertebral injection.Hoarseness occurred in 6 patients (17.1％) and Homer syndrome occurred in 3 patients (8.6％).The median cold sensory visual analogue scale score was 1.2 [0,5] points at 10 minutes after the procedure.Patient's satisfaction score was 9.5 points.Conclusion Ultrasound-guided CRB plus superficial block can achieve accurate and safe anesthesia,and it provides lasting analgesic effect during and after MIP.关键词
超声引导/颈神经根阻滞/甲状旁腺腺瘤切除术Key words
ultrasound-guided/cervical nerve root block/parathyroidectomy分类
医药卫生引用本文复制引用
李旭,李敏娜,崔旭蕾,唐帅,胡亚,廖泉,黄宇光..超声引导下C4神经根加颈浅丛阻滞在微创甲状旁腺手术中的应用[J].中国医学科学院学报,2017,39(5):688-692,5.基金项目
北京协和医学院创新团队发展计划 Supported by the Peking Union Medical College Innovative Team Development Program （）
