气管插管前无阿片诱导复合气管内表面麻醉的可行性  

Observing the feasibility of no opioid induction combine with trachea topical surface anesthesia before intubation

作　　者：邹亮[1] 原皓[1] 王海燕[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院麻醉科,北京100021

出　　处：《中国医刊》2015年第7期80-82,共3页Chinese Journal of Medicine

摘　　要：目的探讨甲状腺手术全麻时不使用阿片类药物诱导的可行性。方法 ASAⅠ～Ⅱ级甲状腺癌患者120例,随机分为两组,气管插管前组Ⅰ诱导时输注芬太尼,组Ⅱ使用2%利多卡因3ml进行气管内表面麻醉,插管成功后持续输注雷米芬太尼,两组均监测诱导前,气管插管即刻,气管插管后5分钟,手术开始血压、心率。结果组Ⅰ（芬太尼组）：与插管前比较插管时心率及血压均无明显变化;与插管即刻比较插管后5分钟及手术开始时血压明显下降,而心率在手术开始时明显下降。组Ⅱ（表面麻醉组）：与插管前比较插管时只有收缩压下降;与插管即刻比较插管后5分钟及手术开始收缩压均有下降,而舒张压及心率在手术开始时下降明显。两组间数据没有显著差异。结论麻醉诱导不使用阿片药而辅以2%利多卡因气管内表面麻醉可有效预防气管插管反应。Objective To explore the feasibility of no opioid induction during general anesthesia for thyroid surgery.Method 120 cases suffering from thyroid cancer with ASA Ⅰ ～ Ⅱ were randomly divided into 2 groups,group Ⅰwere inducted with fentanyl and group Ⅱ with 3ml of 2% lidocaine for trachea topical surface anesthesia before endotracheal intubation. Continuous infusion of remifentanyl after intubation. Then recorded the blood pressure,heart rate at the time point of before induction,intubation,5min after intubation,beginning of operation. Result There were no obvious change in BP at the time point of intubation comparing to time of before induction（ P〉0. 05）,BP decreased significantly at 5min after intubation and beginning of operation comparing to intubation,HR decreased significantly at beginning of operation comparing to intubation in group Ⅰ,only SBP decreased significantly at time of intubation comparing to before induction beginning of operation comparing with intubation. SBP decreased significantly at time of 5min after intubation and beginning of operation comparing to intubation while DBP and HR decreased significantly at the time of beginning of operation in group Ⅱ,there＇s no significant difference in SBP,DBP and HR between group Ⅰ and group Ⅱ at all the time points. Conclusion Trachea topical surface anesthesia using2% lidiocaine and no opioid during induction can effectively prevent intubation reaction.

关 键 词：无阿片诱导 气管内表面麻醉 插管反应 

分 类 号：R614[医药卫生—麻醉学]