Clinical Study On The Application Of Ultrasound-guided Internal Branch Block Of Superior Laryngeal Nerve During Tracheal Extubation Period In Elderly Patients With Hypertension

Objective:To evaluate the effects of ultrasound-guided internal branch block of superior laryngeal nerve during tracheal extubation period in elderly patients with hypertension.Methods:Sixty hypertensive patients,scheduled for laparoscopic cholecystectomy under general anesthesia with endotracheal intubation,were randomly divided into two groups:ultrasound-guided internal branch block of bilateral superior laryngeal nerve(group U)and blank control group(group C)with 30 cases in each group.When the gallbladder was separated,in the group U,the internal branch of bilateral superior laryngeal nerve were blocked under ultrasound guidance,and 1% lidocaine hydrochloride was injected 2mL in each side.In the group C,no internal branch of superior laryngeal nerve was blocked.The two groups were given extubation after meeting the indication of extubation.Before tracheal extubation(T0),tracheal extubation at the same time(T1),1min after tracheal extubation(T2)and 5 min after tracheal extubation(T3),arterial systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)were recorded;arterial blood samples were taken to measure the plasma concentration of cortisol(Cor),dopamine(DA)and norepinephrine(NE)at the same time.Results:The levels of SBP,DBP,HR,Cor,DA and NE at T1 ~ T3 in group C weresignificantly higher than those in T0,The difference is statistically significant(P < 0.05);compared with group U,there were significantly higher in SBP,DBP,HR,Cor,DA and NE at T1 ~ T3 at the time in group C,The difference is statistically significant(P <0.05).Conclusion:Ultrasound-guided internal branch block of superior laryngeal nerve can effectively inhibit the stress response during tracheal extubation period in elderly patients with hypertension and make the elderly patients with hypertension safer and smoother during tracheal extubation period.