The Effect Of Ultrasound-Guided Greater And Lesser Occipital And Occipital Nerve Block In The Treatment Of Cervical Hyperextension And Cerebral Circulation Disorder Syndrome In Thyroid Surgery

Objective:Was to evaluate the effect of ultrasound-guided greater and lesser occipital and occipital nerve block in the treatment of cervical hyperextension and cerebral circulation disorder syndrome in thyroid surgery.Methods:A total of 60 patients experienced the headache after total thyroidectomy or subtotal thyroidectomy under general anesthesia and selective tracheal intubation were enrolled in this study.They were divided into ultrasound-guided greater and lesser occipital nerve block group(group A,n=30)and blank control group(group B,n=30)using a random number table method.When the headache occurred after operation,the patients in the group A received the bilateral ultrasound-guided greater and lesser occipital nerve block,namely 0.5% ropivacaine and 2mg dexamethasone injection(3ml)for each side of greater occipital nerve,the same injection of 2 ml for the bilateral lesser occipital nerves.While the patients in the group B received the same dose of saline for the bilateral greater and lesser occipital nerves under ultrasound guidance.Visual analogue scale(VAS)of headache,24 h nausea and vomiting scores and sleep quality scores were recorded before nerve block,2h nerve block,4h nerve block,8h nerve block and 24 h nerve block,respectively.Results:Nausea,vomiting and sleep disorders were observed in groups A and B within 24 hours after operation.The incidence of nausea and vomiting was 56.7% in the group B,in which the nausea and vomiting(grade 3)accounted for 11.76% of the total incidence,while the incidence was 33.3% in the group A,with no nausea and vomiting(grade 3)patients.The incidence of sleep disorders in the B group was 86.7%,in which the severe sleep disorders accounted for 15.38% of the total incidence,while the incidence was 56.7% in the group A,in which the severe sleep disorders accounted for5.88% of the total incidence.The difference in VAS scores was not statistically significant(P>0.05)in the group B between T0(4.37±1.01)and T1(4.29±1.05).A downward trend was seen within T2-T4(T2 4.05±0.85 T3 3.06±0.94 T4 1.74±0.87)and the VAS scores were lower than those at T0 and T1(P<0.05).A downward trend was shown within T0-T4(T0 4.52±0.98 T1 3.55±1.03 T2 1.87±0.77 T3 1.51±0.69 T4 0.82±0.66)in the group A,and the difference was not statistically significant(P<0.05).Intergroup comparison The scores(VAS)of T1-T4 in the group A were significantly lower than those in the group B(P<0.05),and the difference was statistically significant(P<0.05).The difference was not statistically significant(P>0.05)at T0.Conclusion:Ultrasound-guided bilateral greater and lesser occipital nerve block can effectively suppress the headache,nausea,vomiting and sleep disturbance caused by cervical hyperextension and cerebral circulation disorder syndrome after thyroid surgery.It can alleviate the postoperative pain of thyroid surgery patients and provide a stable and comfortable postoperative recovery condition for them.