1%利多卡因局部麻醉联合静脉全身麻醉在小儿胃镜中的应用  

1% Lidocaine local anesthesia union vein general anesthesia applied in pediatric gastroscope

作　　者：邓军[1] 赵兰花[2] 黄仕英[1] 李明良[1] 韦克[1] 

机构地区：[1]右江民族医学院附属医院麻醉科,广西百色533000 [2]广西壮族自治区百色市妇幼保健院产科,广西百色533000

出　　处：《中国医药导报》2014年第16期84-87,共4页China Medical Herald

基　　金：广西壮族自治区右江民族医学院资助项目(项目编号:YY2013KY003)

摘　　要：目的比较利多卡因局部麻醉联合静脉麻醉与全凭静脉麻醉对患儿呼吸以及复苏的影响，寻求一种呼吸抑制轻、苏醒快速的小儿胃镜麻醉方法。方法将右江民族医学院附属医院2011年7月～2013年7月收治的40例患儿随机分两组：联合组，全凭静脉麻醉（TIVA）组。在两组患儿氯胺酮基础麻醉（肌内注射）后，1％利多卡因5mL经联合组患儿鼻腔行喉、会厌局部麻醉；5min以后，两组患儿用丙泊酚和芬太尼静脉麻醉，开始无痛胃镜镜检。观察两组患儿给药后3、6min心率、呼吸频率、呼吸抑制、静脉用药量、胃镜镜检时间以及苏醒时间。结果静脉给药3min后，联合组与TIVA组心率、呼吸频率以及脉搏氧饱和度分别为（109．04±19．09）次/min、（85．70±21．92）次/min，（1947±2．33）次／min、（14．73±6．05）次／min，（94．94±4．71）％、（87．95±6．60）％，差异均有统计学意义（t=3．59、3．17、3．85，均P〈0．05）。静脉给药6min后，联合组与TIVA组心率、呼吸频率以及脉搏氧饱和度分别为（113．98±25．03）次／min、（91．96±16．82）次／min，（26．07±2．86）次／min、（22．29±5．00）次／min，（98．01±1．35）％、（94．77±2．87）％，差异均有统计学意义（t=3．27、2．98、2．43，均P〈0．05）。给药3min，联合组与TIVA组呼吸抑制例数分别为9、16例，差异有统计学意义（x^2=5．22，P〈0．05）。给药6min，联合组与TIVA组呼吸抑制例数分别为5、12例，差异有统计学意义（x^2=5．01，P〈0．05）。联合组与TIVA组静脉用药量、胃镜镜检时间及复苏时间比较．差异均有统计学意义（P〈0．01或P〈0．05）。结论1％利多卡因局麻联合静脉麻醉是呼吸抑制轻、苏醒迅速的小儿胃镜麻醉方法。Objective To compare the influence of children respiratory and anesthesia recovery in pediatric pain-free gastrocopy between lidocaine locally anesthesia united intravenously general anesthesia and total intravenous general anesthesia, to find a less respiration suppression and quickly anesthetic recovery of pediatric gastroscopy anesthesia. Methods 40 children in the Affiliated Hospital of Youjiang Medical University for Nationalities from July 2011 to July 2013 were randomly divided into two groups, the united group and total intravenous anesthesia （TIVA） group. After Ketamine was basically anesthetized in hospitalized children of both groups （intramuscular injection）, epiglottis and laryngeal was locally anesthetized by 1% Lidocaine （5 mL） trans-nasal cavity in the united group. After five minutes, Propofol and Fentanyl were intravenously anesthetized in both groups, respectively. Then painless gastroscope examination was begun. The pediatric heart rate, respiration rate, respiratory depression, intravenous doses, gastroscope examination time and the recovery time of both groups were respectively monitored after using drug 3 minutes and 6 minutes. Resuits After venous using drug 3 minutes, heart rate, breathing rate and pulse oxygen saturation in the united group and in TI VA group were （109.04±19.09）, （85.70±21.92） times/min; （19.47±2.33）, （14.73±6.05） times/rain; （94.94±4.71）%, （87.95±6.60）%, respectively, the differences were statistically significant （t = 3.59, 3.17, 3.85, all P 〈 0.05）. After venous using drug 6 minutes, heart rate, breathing rate and pulse oxygen saturation in the united group and in TIVA group were （113.98±25.03）, （91.96±16.82） times/ rain; （26.07±2.86）, （22.29±5.00） times/min; （98.01±1.35）%, （94.77±2.87）%, respectively, the differences were statistically significant （t = 3.27, 2.98, 2.43, all P 〈 0.05）. Respiratory depression cases after using drug 3 minutes in the united group and those in TIVA group w

关 键 词：利多卡因 局麻联合静脉麻醉 小儿胃镜 呼吸抑制 

分 类 号：R614.2[医药卫生—麻醉学]