Analgesic Effect Of Ultrasound-guided Superior Laryngeal Nerve Block In Laryngectomy Patients

Objective:To figure out the effect of ultrasound-guided superior laryngeal nerve block in laryngectomy and its effect on post operation pain.Methods:40 patients with laryngectomy for laryngeal carcinoma were selected in this study.All the patients were enrolled in the group from June 2019 to June 2020 and divided into two groups: control group(20 cases)and observation group(20 cases).The control group received general anesthesia and maintained by vein during the operation.The observation group received general anesthesia combined with ultrasound-guided superior laryngeal nerve block.All patients of these two groups were given patient-controlled intravenous analgesia(PCIA)after operation.Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were recorded before induction(T1),immediately after cutting skin(T2),30 min after cutting skin(T3),60 min after cutting skin(T4),and before getting out(T5)to evaluate intraoperative hemodynamic status.Record the dose of vasoactive drugs,anesthetics and drugs used during the operation.Use the method of the visual analog pain score(VAS)to estimate the post operation pain at 4h,8h,12 h,24h,48 h after anesthesia recovery.Record the number of patients with agitation,nausea,vomiting and choking in PACU.Results:In the field of age,gender,ASA classification,BMI,preoperative complications and other baseline data,we found no significant difference(P>0.05)between the control group and the observation group.On the basis of there is no significant difference(P>0.05)in the dose of nicardipine,epinephrine and ephedrine used during the operation between the two groups,the amount of propofol,sufentanil and remifentanil used in the observation group was significantly less than that in the control group(P<0.05).There were no significant differences in SBP,DBP and HR between the two groups before induction(P>0.05),and the circulatory system fluctuation of the experimental group was smaller than that of the control group at each time point during operation,the difference was statistically significant(P <0.05).The number of cases of agitation,nausea,vomiting and choking in PACU in experimental group was less than that in control group,and the difference was statistically significant(P<0.05).Conclusion:Ultrasound-guided superior laryngeal nerve block provides more adequate analgesia for patients undergoing laryngeal carcinoma radical operation.It can also reduce the perioperative dose of opioid analgesics as well as the intraoperative use of sedatives and analgesics.