复方利多卡因乳膏用于OSAHS患者改良腭垂腭咽成形术后鼻咽通气道置入的效果观察  

Effects of compound lidocaine cream for obstructive sleep apnea syndrome patients with nasopharyngeal airway insertion after uvulopalatopharyngoplasty

作　　者：李娜 吴超瑜 魏小龙 刘尚昆 LI Na;WU Chaoyu;WEI Xiaolong;LIU Shangkun(Department of anesthesiology,Tongji Hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology,Wuhan,Hubei,430030)

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030

出　　处：《中西医结合护理（中英文）》2018年第3期8-11,共4页Journal of Clinical Nursing in Practice

基　　金：国家自然科学基金资助项目(81600938)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者改良腭垂腭咽成形术(UPPP)后鼻咽通气道置入时使用复方利多卡因乳膏的效果。方法 116例择期全麻下UPPP术后需留置鼻咽通气道的患者随机分为对照组和观察组,各58例。对照组采用石蜡油均匀涂抹鼻咽通气道后置管,观察组采用复方利多卡因乳膏涂抹后进行置管。观察2组术后置管前后不同时点的心率(HR)、平均动脉压(MAP),对比苏醒期躁动评分、鼻腔黏膜疼痛视觉模拟评分法(VAS)评分,记录患者清醒后自主拔除通气道、通气道拔出后局部黏膜阻塞感发生情况。结果观察组在置入通气道时HR、MPA值均低于对照组(P<0.01);观察组苏醒期躁动平均评分为(1.35±0.37)分,低于对照组的(2.47±0.37)分(P<0.01);观察组鼻腔黏膜疼痛VAS评分(4.48±1.26)分,低于对照组的(6.14±0.83)分(P<0.01)。观察组清醒后自主拔通气道、鼻腔局部阻塞感发生率低于对照组(P<0.01)。结论应用利多卡因乳膏润滑鼻咽通气道置入段,能够提高OSAHS患者UPPP术后留置鼻咽通气道期间患者的耐受程度,减少苏醒的躁动,降低患者清醒后自主拔除通气道等不良事件发生风险。Objective To investigate the effect of compound lidocaine cream for obstructive sleep apnea syndrome(OSAHS)patients with nasopharyngeal airway insertion after uvulopalatopharyngoplasty(UPPP).Methods Totally 116 patients undergoing elective UPPP under general anesthesia and postoperative nasopharyngeal airway insertion were randomly divided into control group and observation group,with 58 cases in each group.In the control group,the paraffin oil was applied to the surface of nasopharyngeal airway before insertion.In the observation group,the compound lidocaine cream was used before nasopharyngeal airway insertion.The heart rate(HR),mean arterial pressure(MAP),sedation-agitation scale and visual analogue scale(VAS)on pain of nasal mucosa were observed at different time points of nasopharyngeal airway insertion.The incidence of adverse events such as autonomous extubation of airway and nasal obstruction were compared between two groups.Results The HR and MPA were lower in the observation group than those of the control group at the time of airway insertion(P<0.01).The sedation-agitation scale of patients was(1.35±0.37)in the observation group and was(2.47±0.37)in the control group,with a significant difference(P<0.01).The VAS on pain of nasal mucosa in the observation group was lower than that of the control group(4.48±1.26 vs.6.14±0.83,P<0.01).There were fewer patients with autonomous extubation of airway or nasal obstruction in the observation group after anesthesia recovery(P<0.01).Conclusion The compound lidocaine cream as lubrication solution used before can effective increase the tolerance of patients with nasopharyngeal airway insertion after UPPP.It is potentially effective to reduce the incidence of emergence agitation and unplanned extubation of airway during anesthesia recovery period.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 腭垂腭咽成形术 复方利多卡因 鼻咽通气道 气道耐受性 麻醉 手术护理 

分 类 号：R472.3[医药卫生—护理学]