利多卡因乳膏减轻颅脑手术拔管反应的临床观察  

The effect of extubution reaction in craniocerebral surgery using lidocaine-prilocaine cream

作　　者：万成福[1] 崔湧[1] 马虹[1] 聂宏光[2] 

机构地区：[1]中国医科大学附属第一医院,110001 [2]中国医科大学基础医学院

出　　处：《山西医药杂志（上半月）》2011年第11期1059-1061,共3页Shanxi Medical Journal

基　　金：国家自然科学基金(30971181)

摘　　要：目的观察利多卡因乳膏对颅脑手术患者拔管反应的临床效果。方法 60例行开颅手术患者随机分成2组:利多卡因乳膏组(L组)和对照组(C组)。L组用利多卡因乳膏3g均匀涂抹于导管前端3cm,C组相同部位涂抹等量凡士林。分别记录患者诱导前(T0)、入麻醉后恢复室即刻(T1)、拔管即刻(T2)和拔管后2min(T3)的收缩压(SP)、舒张压(DP)、心率(HR)和脉搏血氧饱和度(SpO2),相应计算出拔管前后血流动力学变化差值(△SP、△DP、△HR),抽取相应时段血液测定血浆肾上腺素(AD)及去甲肾上腺素(NE)浓度,并记录2组患者拔管反应发生率。结果同C组比较,L组T2、T3时SP、DP、HR、血浆AD及NE浓度明显低于C组(P<0.05);同C组比较,L组SPmax、DPmax、HRmax及△SP、△DP、△HR降低(P<0.05);同C组拔管反应(67%)比较,L组(10%)发生率明显降低。结论复方利多卡因乳膏用于颅脑手术患者可以抑制拔管期间心血管反应,减轻拔管反应,具有良好的表面麻醉效果。Objective To observe the efficacy of lidocaine-prilocaine cream（EMLA） during endotracheal extubation in craniocerebral surgery.Methods Sixty patients undergoing craniotomy were randomized into two groups：group L and group C.L group smeared evenly Lidocaine-prilocaine cream（3 g） over tracheal tube before anesthesia induction.SP,DP,HR and SpO2 were recorded at different time（before induction,at the time to PACU,at the time of extubation and 2 min after extubation）.Then △SP,△DP and △HR were calculated.We also recorded the level of AD and NE for each time.Results Compared with C group,trial group had much lower change in SPmax,DPmax,HRmax,△SP,△DP,△HR,AD and NE.The incidence of extubation reaction in L group（10%） was also lower than C group（67%）.Conclusion Surface anesthesia using Lidocaine-prilocaine cream in craniocerebral surgery could decrease the fluctuation of hemodynamics and depress extubation reaction.

关 键 词：利多卡因 颅脑手术 拔管反应 

分 类 号：R614[医药卫生—麻醉学]