不同浓度罗哌卡因应用于超声引导下 星状神经节阻滞在甲状腺手术中的 效果评价

Evaluation of the Effects of Different Concentrations of Ropivacaine in Ultrasound-Guided Stellate Ganglion Block during Thyroid Surgery

摘要: 目的：探讨不同浓度罗哌卡因应用于超声引导下星状神经节阻滞在甲状腺手术中的临床效果，以优化围手术期麻醉管理方案。方法：选取2024年9月~2025年9月在内蒙古自治区人民医院行甲状腺手术的患者90例，根据局麻药用药浓度分为三组，A组：0.2%罗哌卡因4 mL；B组：0.3%罗哌卡因4 mL；C组：0.4%罗哌卡因4 mL。主要观测指标包括VAS疼痛评分、甲状腺术后体位综合征发生率、术中血流动力学、患者满意度及不良反应。结果：(1) 患者甲状腺术后体位综合征发生率：B组和C组的发生率显著低于A组(P < 0.05)；(2) 术后12 h、24 h静息VAS评分：B组、C组显著低于A组(P < 0.05)，且B组和C组之间差异无统计学意义(P > 0.05)；(3) 患者术后满意度：B、C组均高于A组(P < 0.05)；(4) 术中各时间心率、平均动脉压、血氧饱和度三组比较差异无统计学意义(P > 0.05)；(5) 三组患者术后不良反应发生率差异没有统计学意义(P > 0.05)。结论：0.3%罗哌卡因用于超声引导下星状神经节阻滞，可以显著降低甲状腺术后体位综合征发生率，改善术后镇痛效果并且提高患者满意度，且血流动力学、安全性良好。在效果上与0.4%罗哌卡因相当的前提下，0.3%罗哌卡因更具有临床优势，可以作为优先推荐浓度。

Abstract: Objective: To explore the clinical efficacy of different concentrations of ropivacaine in ultra-sound-guided stellate ganglion block for thyroid surgery, and to optimize the perioperative anesthesia management plan. Methods: A total of 90 patients who underwent thyroid surgery at Inner Mongolia Autonomous Region People’s Hospital from September 2024 to September 2025 were selected. They were divided into three groups according to the concentration of local anesthetic drugs: Group A: 0.2% ropivacaine 4 mL; Group B: 0.3% ropivacaine 4 mL; Group C: 0.4% ropivacaine 4 mL. The main observation indicators included VAS pain score, incidence of postoperative body position syndrome, intraoperative hemodynamics, patient satisfaction, and adverse reactions. Results: (1) Incidence of postoperative body position syndrome in patients: The incidence in Group B and Group C was significantly lower than that in Group A (P < 0.05); (2) Resting VAS scores at 12 h and 24 h after surgery: The scores in Group B and Group C were significantly lower than those in Group A (P < 0.05), and there was no statistically significant difference between Group B and Group C (P > 0.05); (3) Postoperative satisfaction of patients: Group B and Group C were both higher than Group A (P < 0.05); (4) Comparison of heart rate, mean arterial pressure, and blood oxygen saturation at different time points during surgery among the three groups showed no statistically significant difference (P > 0.05); (5) There was no statistically significant difference in the incidence of postoperative adverse reactions among the three groups (P > 0.05). Conclusion: 0.3% ropivacaine for ultrasound-guided stellate ganglion block can significantly reduce the incidence of postoperative body position syndrome, improve postoperative analgesic effect, and increase patient satisfaction. The hemodynamics and safety are good. Under the condition that the effect is equivalent to 0.4% ropivacaine, 0.3% ropivacaine has more clinical advantages and can be recommended as the preferred concentration.