喉麻管在气道或食道异物取出术麻醉中的应用  

Application of laryngotracheal topical anesthesia kit in removing foreign body from trachea or esophagus

作　　者：马永兵 陆雅萍[2] 黄冰[2] 

机构地区：[1]浙江省荣军医院麻醉科,嘉兴314000 [2]浙江省嘉兴学院医学院附属第一医院麻醉科

出　　处：《临床医学》2008年第2期15-16,共2页Clinical Medicine

摘　　要：目的观察喉麻管在气道或食道异物取出术麻醉中的应用。方法选择ASAⅠ-Ⅱ级行气道或食道中异物取出术的病人40例,随机分为两组,每组20例,Ⅰ组（观察组）：静脉注射东莨菪碱0.1-0.3 mg、氯胺酮1 mg/kg、异丙酚1.5 mg/kg后用弯喉镜显露声门,喉麻管接含有2%利多卡因2.5 ml的针筒行气管内或食道内表面麻醉。Ⅱ组（对照组）：静脉注射药物（同Ⅰ组）后咽喉部用普通喷雾器以2%利多卡因喷洒。操作术中静脉推注异丙酚15-20μg/（kg.min）维持麻醉。分别记录两组病人麻醉前、表面麻醉时、手术关键操作时的血压（收缩压SBP）、心率（HR）、脉搏血氧饱和度（SpO2）的变化。结果Ⅰ组病人麻醉及手术过程中血压（BP）、HR、SpO2平稳,Ⅱ组病人则BP、HR、SpO2波动较大,两组间比较差异有统计学意义（P〈0.05）。结论喉麻管利多卡因喷洒用于气道、食道异物取出手术中有良好的麻醉效果,对维持血流动力学和SpO2的稳定有显著意义。Objective To investigate the application of the laryngotracheal topical anesthesia kit in removing the foreign body from the trachea or esophagus. Methods Forty ASA Ⅰ - Ⅱ patients,who needed to remove the foreign body from the trachea or esophagus,were divided randomly into two groups：group Ⅰ （ n =20） and group Ⅱ （ n = 20）. All patients of both groups were induced with scopolamine 0.1 -0.3 mg,ketamine 1 mg/kg,propofol 1.5 mg/kg intravenous. Then,the patients of group Ⅰ received 2% lidocaine 2. 5 ml topical anesthesia to the endotracheal or esophageal mucosa by the laryngotracheal topical anesthesia kit, after visualization of the glottis by the laryngoscopy. While the patients of group Ⅱ received 2% lidocaine 2.5 ml topical anesthesia by a common atomizer. All patients were given propofol 15 -20 μg/（ kg · min） intravenous to maintain anesthesia during the operation. BP,HR and SpO2 were recorded before the anesthesia,during the topical anesthesia and during the operation. Resuits The patients of group Ⅰ had more stable BP, HR and SpO2 than those of group Ⅱ during the anesthesia and operation. Statistical differences were found between the two groups （ P 〈 0.05）. Conclusion The laryngotracheal topical anesthesia kit can obtain better lidocaine topical anesthesia than a common atomizer. It helps to maintain the blood circulation and SpO2 stable.

关 键 词：气-食道异物 表面麻醉 喉麻管 

分 类 号：R614[医药卫生—麻醉学]