丁卡因表面麻醉对全麻甲状腺手术患者拔管期的影响  

Effects of topical anesthesia with tetracaine during tracheal extubation period in patients undergoing thyroid surgery

作　　者：王茜[1] 刘钢[1] 陈晓光[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,辽宁沈阳110001

出　　处：《中国新药与临床杂志》2014年第7期498-501,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：辽宁省教育厅高校科研计划项目(2009A727)

摘　　要：目的评价丁卡因表面麻醉对全麻甲状腺手术患者气管拔管期间的影响。方法择期拟行全麻下甲状腺肿物切除术患者40例,随机分为试验组和对照组,每组20例。待患者入睡后、气管插管前,试验组窥喉予0.5%丁卡因喷于咽喉和气管内,共2 mL,对照组予等量氯化钠注射液。两组均面罩吸氧后气管插管,术中静脉麻醉维持。记录两组拔管前,拔管即刻,拔管后1、2、3 min收缩压(SBP)、平均动脉压(MAP)、心率收缩压乘积(RPP),观察对比术后清醒时的耐管效果,及术后出血量等不良反应。结果试验组拔管前后SBP、MAP、RPP无显著变化(P>0.05),对照组拔管后SBP、MAP、RPP均升高(P<0.05),且高于试验组,差异有显著意义(P<0.05)。试验组和对照组耐管效果评优率分别为80%和5%,试验组耐管情况优于对照组(P<0.05)。试验组和对照组的术后出血量分别为(25.0±8.6)和(36.9±15.0)mL,试验组术后出血量少于对照组(P<0.05)。结论气管内丁卡因表面麻醉能够增强全麻甲状腺手术患者术后清醒时的耐管效果,并能预防拔管引起的心血管反应,降低术后出血量。AIM To evaluate the effects of topical anesthesia with tetracaine during tracheal extubation period in patients undergoing thyroid surgery. METHODS Forty patients scheduled for thyroid surgery were randomly divided into two groups （n = 20）. Between induction and tracheal intubation, the topical anesthesia was applied to throat and trachea with 0.5% tetracaine 2 mL in the trial group, and sodium chloride injection 2 mL in the control group. After that, the endotracheal intubation was performed in both groups. Total intraveneous anesthesia was used for the maintenance of anesthesia. The systolic blood pressure （SBP）, mean arterial pressure （MAP）, and heart rate-blood pressure product （RPP） before extubation and all subsequent 0, 1, 2, 3 min were recorded. The reaction to tolerate tube when the patients were conscious and the amount of postoperative blood loss were observed. RESULTS The patients in the trial group had no significantly change in SBP, MAP and RPP before and after the extubation （P 〉 0.05）. The SBP, MAP and RPP in the control group increased significantly after extubation （P 〈 0.05） and were higher than those in the trial group （P 〈 0.05）. The tube resistant effect assessment rate was 80% and 5% in the trial group and control group （P 〈 0.05）. The amount of postoperative blood loss of the trial group was lower compared with that in the control group （ （25.0 ±8.6） mL vs. （36.9 ± 15.0） mL, P 〈 0.05）. CONCLUSION The topical anesthesia with tetracaine can enhance tube tolerance after thyroid surgery, attenuate the hemodynamic response to tracheal extubation, and reduce the postoperative bleeding.

关 键 词：丁卡因 麻醉 局部 麻醉 气管内 气管拔管期 甲状腺手术 

分 类 号：R971.2[医药卫生—药品]