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目的：采用两种不同的颈丛神经阻滞方法应用于甲状腺腺瘤切除术，比较其麻醉效果及对循环的影响。方法：50例ASAⅠ－Ⅱ级择期甲状腺腺瘤病人，随机分成两组，每组25例。Ⅰ组采用C3深丛阻滞（相当于C3横突处一点）及浅丛阻滞法（胸锁乳突肌后缘中点）;Ⅱ组用C3、C4深丛阻滞法（相当于C3、C4横突处各一点）及浅丛阻滞法。均以20ml注射器及v号3．5cm针头进行须深丛和颈浅丛神经阻滞。颈深丛阻滞注入1．14％利多卡因与0．14％丁哌卡因混合液，单测一点4~6ml，两点即8－12ml，双侧一点8~12ml，两点即16~24ml（均不加肾上腺素）。颈浅丛阻滞用1．33％利多卡因及0．25％布比卡因，单侧10ml，双侧20ml。观察两组阻滞前后BP和HR变化情况。结论：两组阻滞麻醉效果没有显著性差异，但是两种阻滞方法对循环的影响却不同，有显著性差异（P＜0．05）。从阻滞后5~30minBP升高平均值和HR增加方面看Ⅰ组对循环影响较轻，Ⅱ组则较大。C3主要支配颈部区域，浅丛支配皮肤和浅表结构，对甲状腺腺瘤手术来说，二者配合应用，麻醉效果满意，用药量小，对迷走神经阻滞较轻，对循环系统影响相对轻，副作用小，值得应用。
Objective: To use two different methods of cervical plexus block for thyroid adenoma resection, compare its anesthetic effect and its effect on circulation. Methods: Fifty patients with ASA I-II elective thyroid adenoma were randomly divided into two groups with 25 cases in each group. Group I was treated with C3 deep plexus block (equivalent to a point at the C3 transverse plane) and shallow plexus block (the midpoint of the posterior edge of the sternocleidomastoid muscle); Group II was treated with C3 and C4 deep plexus block (equivalent to C3). , C4 cross-section at each point) and shallow clump block method. The deep plexus and superficial cervical plexus block were performed with a 20 ml syringe and a V 3.5 cm needle. Deep cervical block injection of 1.14% lidocaine and 0.14% bupivacaine mixed solution, a single measurement point 4 ~ 6ml, two points 8-12ml, a little bit of bilateral 8 ~ 12ml, two points 16 ~24ml (no adrenaline). Superficial cervical plexus block with 1.33% lidocaine and 0.25% bupivacaine, unilateral 10ml, bilateral 20ml. The changes of BP and HR before and after block were observed. Conclusion: There is no significant difference in the effect of block anesthesia between the two groups, but the effect of the two block methods on circulation is different, with significant difference (P<0.05). From the point of view of the increase in the mean value of 5 to 30 min BP arrest and the increase in HR, the effect of group I on the circulation was lighter, and that of group II was greater. C3 mainly govern the neck region, superficial turbinate dominates the skin and superficial structures. For thyroid adenoma surgery, the combination of the two has satisfactory anesthesia effect, small dose, lighter vagal nerve block, and relatively less influence on the circulatory system. The side effects are small and worth applying.