不同麻醉药物在气道表面麻醉时对气管插管及拔管反应的影响分析  

Influences of Different Anesthetics on the Tracheal Intubation and Extubation Reactions in Airway Surface Anesthesia

作　　者：殷悦[1] 王立伟[1] 祖翠华[1] 

机构地区：[1]徐州市中心医院,江苏徐州221009

出　　处：《北华大学学报（自然科学版）》2017年第3期360-364,共5页Journal of Beihua University（Natural Science）

基　　金：江苏省自然科学基金项目(BK20151418)

摘　　要：目的探讨不同麻醉药物行气道表面麻醉时对气管插管及拔管反应的影响.方法选取收治的80例择期行下腹部剖腹手术患者为研究对象,随机分为2%利多卡因组(L组,n=20)、0.75%丁卡因组(T组,n=20)、0.75%罗哌卡因组(R组,n=20)、对照组(C组,n=20),静脉诱导后分别用5 m L上述麻醉药物行气道表面麻醉,其中对照组用5 m L生理盐水.观察记录各组麻醉诱导前、插管即刻、插管后3 min、拔管即刻及拔管后3 min的平均动脉压(MAP)、收缩压(SBP)和心率(HR)情况;记录患者麻醉苏醒期呛咳评分及术后患者不良记忆情况.结果插管后4组患者HR,SBP及MAP较插管前显著升高(P<0.05);与C组比较,插管后各组患者HR,SBP,MAP指标显著偏低(P<0.05),其中R组插管后上述指标较L组、T组显著偏高(P<0.05);拔管时C组HR,SBP,MAP较T组、R组显著偏高(P<0.05),T组上述指标较L组低(P<0.05);T组、R组呛咳评分及拔管时不良回忆评分较L组、C组低(P<0.05).结论与2%利多卡因和7.5%罗哌卡因相比,0.75%丁卡因更能有效地抑制插管反应.Objective To study the influences of different anesthetics on the tracheal intubation and extubation reactions in airway surface anesthesia. Method Clinical data of 80 patients who underwent elective lower abdominal laparotomy were selected, and were divided into four groups randomly ：2% lidocaine group （L group, n = 20） ,0.75 % tetraeaine group （ T group, n = 20 ）, 0.75 % ropivacaine group （ R group, n = 20）, and control group （C group,n=20）. Patients in L group,T group and R group were given the airway surface anesthesia with 5 mL of the anesthetics described above, but those in the C group were given 5 mL of NS. The MAP （mean arterial pressure）, SBP （systolic blood pressure） and HR （heart rate） before the anesthesia induction,just at the intubation,3 minutes after the intuhation, Just at the extubation and 3 minutes after the extubation were measured and recorded, respectively. At the same time, the choking cough score during the anesthesia awakening period and had memory score in patients with postoperative visit were recorded. Results The HR, SBP and MAP of patients in the four groups after the intubation were significantly higher than those before the intubation （ P 〈 0.05 ）.Compared with those in the C group, the HR, SBP and MAP of patients in the other three group were slgmhcantly lower （P〈0.05）, and the HR, SBP and MAP of patients in R group were significantly higher than those in L group and T group （P〈0.05）. The HR, SBP and MAP in C group after the extubation were significantly higher than those in L group and R group （ P〈0.05 ）, but those in T group were significantly lower than those in L group （ P〈0.05 ）. The choking cough score and bad memory score of patients in T group and R group were significantly lower than those in L group and C group （P〈0.05）. Conclusion Compared with 2% lidocaine and 0.75% ropivacaine, tetracaine could more effectively inhibit the intubation reactions.

关 键 词：利多卡因 罗哌卡因 丁卡因 表面麻醉 

分 类 号：R614[医药卫生—麻醉学]