Effect Of Total Intravenous Anesthesia Combined With Ultrasond-guided Superficial Cervical Plexus Block On Anesthesia Quality In Thyroid Surgery

ObjectiveTo observe the effect of total intravenous anesthesia combined with ultrasound guided bilateral superficial cervical plexus block on the quality of anesthesia in radical thyroidectomy.MethodsSixty-four patients who were scheduled to undergo radical thyroidectomy were randomly divided into observation group and control group,with 32 cases in each group.Patients in control group(group C)received radical thyroidectomy under total intravenous anesthesia.Patients in observation group(group T)underwent radical thyroidectomy under total intravenous anesthesia combined with ultrasusionguided superficial cervical plexus block.Primary outcome:VAS(rest and dynamic)scores at 1,hours after surgery.Secondary outcome measures:intraoperative sufentanil dosage in the two groups;VAS(rest and dynamic)scores at 6,24hours after surgery;Sedation and agitation score(SAS)immediately after extubation(T1),5 minutes after extubation(T2),and 10 minutes after extubation(T3);Length of stay in PACU;Patients’ comfort score(BCS)24 hours after operation,dosage of analgesic drug sufentanil 24 hours after operation,postoperative nausea and vomiting,and patients’satisfaction with anesthesia management;Systolic blood pressure and heart rate before operation,systolic blood pressure and heart rate at 2 minutes after skin incision,systolic blood pressure and heart rate before extubation,systolic blood pressure and heart rate at 1 minute after extubation in the two groups.ResultsThe VAS(resting and dynamic)score at 1 hour and VAS(dynamic)score at 6 hours after operation in the observation group were lower than those in the control group(P<0.05).There was no significant difference in VAS score at 6 hours(static)and 24 hours(resting and dynamic)between the two groups(P>0.05).The amount of sufentanil in the observation group was lower than that in the control group(P<0.05);The dosage of sufentanil for postoperative analgesia in observation group was lower than that in control group(P<0.05);The postoperative PACU residence time in observation group was lower than that in control group(P<0.05);The comfort score of the observation group was better than that of the control group 24 hours after operation(P<0.05).The postoperative nausea and vomiting in the observation group was lower than that in the control group(P<0.05).The satisfaction of anesthesia management in the observation group was higher than that in the control group(P<0.05).The systolic blood pressure and heart rate of the observation group were lower than those of the control group at 2 minutes after skin cutting(P<0.05).The systolic blood pressure and heart rate of the observation group at 1 minute after extubation were lower than those of the control group(P<0.05).ConclusionTotal intravenous anesthesia combined with ultrasounds guided superficial cervical plexus block can reduce the incidence of acute pain and sudden agitation in patients undergoing radical thyroidectomy.To reduce intraoperative and postoperative analgesic sufentanil dosage in patients undergoing radical thyroidectomy;It can promote the rapid recovery of patients,shorten the stay time of PACU,improve the postoperative comfort score of patients,reduce the incidence of postoperative nausea and vomiting,and improve the satisfaction of patients with perioperative anesthesia management.The quality of anesthesia is better than pure intravenous anesthesia.