利多卡因三种方式用于预防老年患者全麻插管反应的临床效果观察  

Observation on the Effect of Lidocaine Treated in Three Different Ways on the Prevention of General Anesthesia in the Elderly Patients

作　　者：吕晓红[1] 陈庆民[1] 孙治国[1] 陈猛[1] 温立勇[1] 王秀岩[1] 

机构地区：[1]牡丹江医学院红旗医院,黑龙江牡丹江157011

出　　处：《现代生物医学进展》2017年第24期4699-4701,4705,共4页Progress in Modern Biomedicine

摘　　要：目的:比较利多卡因三种方式在预防老年患者全麻插管反应中的临床效果。方法:选择择期行全麻插管手术美国麻醉师协会(ASA)Ⅰ~Ⅱ级的老年患者(65~85岁)120例,随机分为环甲膜穿刺组(H组)、咽喉表面麻醉组(Y组)、静脉注射组(J组)及对照组(D组)。H组进行环甲膜穿刺注射利多卡因进行表面麻醉;Y组使用喉喷管对咽喉部喷洒利多卡因进行表面麻醉;J组在麻醉诱导时静脉注射利多卡因预防插管反应;D组为不给予利多卡因处置的对照组。监测各组患者诱导前(T0)、气管插管前(T1)和插管后1(T2)、3(T3)、5 min(T4)时收缩压(SBP)和心率(HR),比较四组血流动力学相关指标的变化。结果:同同组T0时刻比较,四组T1时刻SBP和HR均显著降低(P<0.05);同同组T0时刻比较,D组T2、T3、T4时刻SBP和HR均显著升高(P<0.05),另三组T2、T3时刻SBP显著升高(P<0.05),T2时刻HR显著升高(P<0.05);与D组比较,H、Y、J组SBP和HR在T2、T3、T4时刻差异有统计学意义(P<0.05),而三组组间比较差异无统计学意义(P>0.05)。结论:利多卡因三种方式的效果相当,均可用于预防老年患者的全麻插管反应;但环甲膜穿刺法增加了病人的痛苦,咽喉喷雾法增加了操作的繁琐性且提升了病人的费用,而静脉注射法操作简便。Objective：To compare the three effects of lidocaine in the prevention of general anesthesia in elderly patients.Methods：A total of 120 elderly patients（65-85 years old） underwent anesthesia with general anesthesia（ASA） Ⅰ ~ Ⅱ were randomly divided into thyrocricocentesis group（group H）,throat surface anesthesia group（Group Y）,intravenous injection group（group J） and control group（group D）.Group H was injected with lidocaine for surface anesthesia;group Y used laryngeal spray for laryngeal sprayed lidocaine for surface anesthesia;group J was anesthetized induction of intravenous lidocaine to prevent intubation reaction;group D the control group was not treated with lidocaine.（SBP） and heart rate（HR） were measured before and after induction（T0）,tracheal intubation（T1） and 1（T2）,3（T3） and 5 min（T4）,the changes of hemodynamics related indexes were compared.Results：Compared with the same group of T0,the SBP and HR of four groups of T1 moments were significantly decreased（P 〈0.05）;In the other three groups,SBP was significantly increased at T2 and T3（P 〈0.05）,HR of T2 was significantly increased（P 〈0.05）;Compared with group D,SBP and HR in group H,Y and J were significantly different at T2,T3 and T4,he difference was statistically significant（P 〈0.05）;but there was no statistically significant difference between the three groups（P〉 0.05）.Conclusion：The three ways of lidocaine can be used to prevent the general anesthesia reaction in elderly patients,the effect of three ways is parallel.However,cricothyroid membrane puncture increased the patient’s pain,throat spray method increased the cumbersome operation and enhanced the cost of the patient,and intravenous injection method is simple and worthy of popularization and application in clinic.

关 键 词：利多卡因 老年患者 插管反应 

分 类 号：R614.2[医药卫生—麻醉学]