比较双侧颈浅丛阻滞和静注帕瑞昔布对接受甲状腺手术患者术后镇痛效果的影响。

50例接受甲状腺手术患者被分为双侧颈浅丛神经组（A组）和帕瑞昔布组（B组），各25例。A组全麻诱导后用0.5%罗哌卡因进行双侧颈浅丛神经阻滞，B组术前静脉注射帕瑞昔布钠40 mg，记录术中瑞芬太尼的用量。采用VAS评分对术后0、4、8、12、16、20 h及24 h进行疼痛评分，四分法记录术后恶心呕吐情况。

两组患者术后各时间段的VAS评分及24 h需要镇痛药物的比例差异无统计学意义。A组术中瑞芬太尼的用量为（884±238）μg，B组为（1783 ± 262）μg，组间差异有统计学意义（P < 0.05）；A组术后恶心呕吐的发生率为20%（5/25），B组为48%（12/25），组间差异有统计学意义（P < 0.05）。

双侧颈浅丛神经阻滞和静注帕瑞昔布具有相同的术后镇痛效果，双侧颈浅丛神经阻滞复合全麻可降低术中镇痛药物的用量，减少术后恶心呕吐的发生率。

To compare analgesic efficacy and related side effects of bilateral superficial cervical plexus block and intravenous administration of parecoxib in thyroidectomy under general anesthesia.

Fifty patients who underwent thyriodectomy were assigned into bilateral cervical plexus blockade group (group A, 25 cases) or intravenous administration of parecoxib group (group B, 25 cases) . In group A, bilateral superficial cervical plexus was performed after anesthesia induction. In group B, 40 mg parecoxib was administrated intravenously 30 minutes before initiating of procedure. The number of patients asking for analgesics, VAS scores and postoperative nausea and vomiting in 24 h after surgery were assessed.

VAS scores and the number of patients requiring analgesics during first 24 h after operation were similar in two groups. The dosage of remifentanil infused during the procedure was significantly lower in group A (884 ± 238) μg than in group B (1783 ± 262) μg (P < 0.05) . The Inci- dents of postoperative nausea and vomiting was significantly lower in group A than in group B (5/25 vs. 12/25) (P < 0.05) .

Both bilateral superficial cervical plexus blockade and intravenous administration of parecoxib provide good postoperative analgesia in patients undergoing thyriodectomy under general anesthesia. Bilateral superficial cervical plexus blockade reduces intraoperative anesthetics usage, which results in lower posteroperative nausea and vomiting.