复方利多卡因乳膏对气管切开术患者全身麻醉苏醒期的影响  

Effects of compound lidocaine cream on patients with tracheotomy during recovery from general anesthesia

作　　者：陈伟志[1] 林红[1] 陆光泽[1] 

机构地区：[1]广东省高州市人民医院麻醉科,525200

出　　处：《中国医师进修杂志》2014年第21期16-18,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察复方利多卡因乳膏对全身麻醉下行气管切开术患者苏醒期的影响。方法54例全身麻醉下行口腔癌根治和气管切开术患者按随机数字表法分为复方利多卡因乳膏组（L组）和对照组（C组），各27例。L组气切套管气管内段涂抹复方利多卡因乳膏，c组套管不涂任何药物。记录两组诱导前（T0）、术毕（T。）、唤醒即刻（T：）和唤醒后1min（T，）血流动力学参数，术后自主呼吸恢复时间、唤醒时间、恢复室停留时间及呛咳、躁动发生情况。结果两组手术时间、七氟醚吸入总时间、自主呼吸恢复时间、唤醒时间比较差异无统计学意义（P〉0．05），L组恢复室停留时间少于C组[（27．3±6．9）min比（34．9±6．6）min]（P〈0．05）。C组B时心率（HR）、平均动脉压（MAP）明显高于T0[（113．5±18．0）次／min比（82．2±13．1）次／min，（112．7±15．7）mmHg比（87．5±12．7）mmHg;（P〈0．01），L组L时HR、MAP低于C组[（92．6±12.8）次／min比（113．5±18．0）次／rain，（98．3±13．5）mmHg（1mmHg=0．133kPa）比（112．7±15．7）mmHg]（P〈0．01或〈0．05）。L组呛咳程度明显低于C组（Z=-2．409，P〈0．05）。L组躁动程度明显低于C组（Z=-2．013，P〈0．05）。结论复方利多卡因乳膏气管表面麻醉有效抑制气管切开术后的循环波动、呛咳及躁动。Objective To observe the effects of compound lidocaine cream on patients with tracheotomy during recovery from general anesthesia. Methods Fifty-four patients scheduled for radical oral cancer resection and tracheotomy under general anesthesia were randomly allocated into two groups： control group （group C, 27 patients） and compound lidoeaine cream group （group L, 27 patients）. Compound lidocaine cream was uniformly smeared on the airway segment of tracheotomy tube in group L, and no drug was coated on tracheotomy tube in group C. Hemodynamic parameters before induction （To）, at the end of surgery（T1 ）,at the moment of awake（T2） and 1 min after awake（T3）, respiration recovery time, awake time, time spent in the postanesthetic care unit （PACU）, coughing, and agitation after surgery were monitored. Results There were no difference in the operatiota time, sevoflurane inhale time, respiration recovery time and awake time between two groups （P 〉 0.05 ）. The time spent in the PACU in group L was less than that in group C [ （27.3 ± 6.9）rain vs.（34.9± 6.6） minl （P〈 0.05）. The HR and MAP ofT3 in group C were significantly higher than those of To [ （113.5 ±18.0） bpm vs. （82.2± 13.1 ） bpm, （112.7± 15.7 ） mmitg （ 1 mmHg = 0.133 kPa） vs. （ 87.5 ± 12.7 ） mmHg ] （P 〈 0.01 ）. The HR and MAP of T3 in group L were lower than those in group C [（92.6± 12.8） bpm vs.（113.5 ± 18.0） bpm, （98.3 ＋ 13.5） mmHg vs. （ 112.7 ± 15.7 ） mmHg ] （P 〈 0.01 or P 〈 0.05 ）. Degree of coughing in group L was lower than that in group C （Z = -2.409, P 〈 0.05 ）. Degree of agitation in group L was lower than that in group C （Z = -2.013, P 〈 0.05）. Conclusion Topical anesthesia of tracheal mucosa using compound lidocaine cream can effectively alleviate hemodynamics fluctuations, coughing and agitation after tracheotomy during recovery for general anesthesia.

关 键 词：利多卡因 气管切开术 血流动力学 

分 类 号：R459.5[医药卫生—治疗学]