利多卡因用于气管表面麻醉对术后拔管气道反应的影响  

Effect of lidocaine surface anesthesia in the prevention of endotracheal extubation response

作　　者：原皓 邹亮 

机构地区：[1]国家癌症中心/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》2017年第9期79-81,共3页Chinese Journal of Medicine

摘　　要：目的探讨全麻下甲状腺手术插管时应用利多卡因喷喉对于插管反应及拔管反应的预防作用。方法选取2014年2月至2015年3月于本院行全麻下甲状腺手术的患者60例,ASAⅠ或Ⅱ级,随机分为观察组和对照组,每组30例。观察组于诱导后插入喉麻管注入2%利多卡因5ml做声门及声门下气管表面麻醉,之后行气管内插管。对照组肌松完善后直接行气管内插管,机械通气参数同观察组。比较两组患者不同时间点的血流动力学指标及拔管时的呛咳反应。结果与插管前比较,观察组患者插管时心率及血压均无明显变化,拔管时血压无明显变化,心率有明显升高。与插管前比较,对照组患者插管时及拔管时血压均无明显变化,但心率均明显升高。两组患者拔管时呛咳指数比较差异无显著性(P>0.05)。结论麻醉诱导时辅以2%利多卡因喷喉可有效预防气管插管反应,但对拔管时血流动力学及呛咳反应无显著影响。Objective To study the effect of lidocaine surface anesthesia in endotracheal extubation response. Method 60 Patients, of ASA physical statusⅠor Ⅱ, scheduled for selective thyroid surgery, were randomly divided into 2 groups ： control group and lidocaine surface anesthesia group （experimental group）. In experimental group, 2% lidocaine 5ml were given for trachea topical surface anesthesia before endotracheal intubation. Then recorded the hemodynamics indexes in different time points, incidence of cough in extubation and extubation complications occurrences of both groups were compared. Result There were no obvious change in MAP and HR at the time point of intubation comparing to time of before induction, only HR increased significantly at extubation comparing to intubation in experimental group. HR increased significantly at time of intubation comparing to before induction but MAP maintain stable, only HR increased significantly at extubation comparing to intubation in control group There was no significant difference in the incidence of cough in extubation. Conclusion Trachea topical surface anesthesia using 2% lidocaine can effectively prevent intubation reaction but have no effect on hemodynamics indexes and cough induced by tracheal extubation.

关 键 词：利多卡因 喷喉 插管反应 拔管反应 

分 类 号：R614[医药卫生—麻醉学]