| Objective:Effect of Non-opioid Analgesia on Postoperative Analgesia and Recovery in Patients Undergoing Thyroidectomy.Methods:In this paper,92 patients?ASA:level I-II,age:20-70 years old,weight:45-85kg;male:19 cases;female:73 cases?who need elective thyroidectomy were selected.Non-invasive blood pressure was routinely monitored and the peripheral vein of the upper limb was opened after entering the operating room.Pulse oxygen saturation,ECG and BIS were monitored.The induction of general anesthesia in the three groups of patients was carried out by intravenous injection of 0.025mg/kg of liyuexi injection,with the maximum dosage not exceeding 5mg,0.05mg/kg of atracurium besylate,2mg/kg of propofol injection,and 0.5ug/kg of sufentanil citrate.After eyelash reflex disappeared in each group,mask hyperventilation was carried out for 3min,then the special tracheal catheter for monitoring recurrent laryngeal nerve was inserted under visual laryngoscope and mechanical ventilation was carried out.During the operation,remifentanil 4-9ug/kg.h and propofol injection 4-12mg/kg.h were continuously pumped by micro pump to jointly maintain anesthesia.The patients were randomly divided into three groups:Group A?n=30?was treated with PCIA pump containing2ug/kg sufentanil citrate injection after operation;Group B?n=32?received simple general anesthesia and was given oral NSAIDs?celebrex?0.2g after awakening;Group C?n=30?received ultrasound-guided Bilateral Superficial Cervical Plexus Block?BSC PB?with 0.33%ropivacaine 14ml after operation.If the patient suffered from unbearable pain after the operation and NRS scored more than 4,60mg ketorolac was given intramuscularly for remedial analgesia,with a time interval of more than 4 hours.VAS scores of 2h?T1??4h?T2??6h?T3??8 h?T4??12 h?T5??24 h?T6??and48 h?T7?after operation and PONV within 48h after operation;time of first meal?h?;time of first exhaust;number of defecations within 48 hours after operation;bedside activity time?h?;postoperative dizziness and headache of the patients;postoperative drainage volume?ml?,Qor-40 scores of 24h after operation,as well as the block of Group C were recorded.Results:In this study,the age,gender,height,weight and BMI of the three groups had no statistical significance?p<0.05?.The VAS scores of Group C in the first two hours were significantly lower than those of the other two groups?p<0.05?.The VAS scores of Group C were lower than those of Group A and Group B?p<0.05?in the T2-T4hours after awakening.There was no significant difference between the VAS scores of Group A and Group B at T1-T4 hours?p<0.05?.There was no significant difference in VAS scores of Group A,Group B and Group C at T5-T7 hours?p<0.05?.Compared with Group A,patients in Group B and C had less PONV,shorter time of bedside movement and first exhaust?p<0.05?.The defecation frequency of patients in Group B and Group C within 48h after operation had no statistical difference?p>0.05?and was higher than that in Group A?p<0.05?with statistically significant difference.The general condition,postoperative dizziness and headache of the patients in the Group B and C had no statistical significance?p>0.05?.The average drainage volume of the patients in Group C was significantly higher than that in Group A and Group B in 48 hours after operation,and a small number of patients had numbness of upper limb?p<0.05?.The Qor-40 score of group B and C 24 hours after operation was higher than that of group A?p<0.05?without statistical difference?p>0.05?.There were 6 cases of pruritus after operation in Group A?p<0.05?.There are 6 cases of remedial analgesia,2 cases in Group A,2 cases in Group B and 2 cases in Group C respectively,the results were not statistically significant?p>0.05?.Conclusion:Both non-opioid analgesics and traditional opioids can effectively relieve postoperative pain of thyroid surgery.Compared with opioid analgesics.Non-opioid analgesics have fewer postoperative complications and are conducive to accelerating recovery. |
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