气管导管套囊内碳酸利多卡因技术在减肥手术中的应用  

Application of intracuff injection of lidocaine carbonate into tracheal catheter in weight-loss surgery

作　　者：盛崴宣[1] 韩阳 关雷[1] SHENG Wei-xuan;HAN Yang;GUAN Lei(Anesthesia Department, Hospital of Century Altar , Beijing 100038)

机构地区：[1]首都医科大学附属世纪坛医院麻醉科,北京100038 [2]首都医科大学附属世纪坛医院手术室,北京100038

出　　处：《中国实验诊断学》2019年第3期414-416,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨气管导管套囊内注入碳酸利多卡因在减肥手术中拔管时的应用价值。方法选择择期腹腔镜袖状胃切除术80例,随机分为2组,各40例:A组,插管后向气囊内缓慢注入空气;C组,插管后向气囊内缓慢注入1.73%碳酸利多卡因;记录诱导前(T1)、拔管即刻(T2)、拔管后5 min(T3)的平均动脉压(mean artery pressure,MAP)和心率(heart race,HR);记录拔管呛咳评分;记录拔管后0.5、1、2、6、24h咽痛视觉模拟评分(visual analogue scale,VAS)。结果两组患者基本情况无统计学差异。与A组比较,C组T1、T2时间点HR、MAP无明显差异;T3时间点的HR(A组101.5±13.5、C组86.8±11.5)、MAP(A组98.8±12.1、C组85.6±11.4)均低于A组,P<0.05。C组拔管时的呛咳评分(2.1±0.4)明显低于A组(3.4±0.3),P<0.05;拔管后0.5、1、2、6、24h咽痛VAS评分比较,C组各个时间点评分明显低于A组,P<0.05。结论气管导管套囊内注入碳酸利多卡因能有效地减少拔管的心血管反应,降低术后呛咳和咽痛的发生率。Objective Investigate the efficacy of intracuff injection of lidocaine carbonate into tracheal catheter in the prevention of tracheal extubation response in weight-loss surgery.Methods 80 patients scheduled for(laparoscopic sleeve gastrectomy were randomly divided into 2 groups.Air was filled into tracheal intubation airbag in group A.1.73% lidocaine carbonate was filled into tracheal intubation airbag in group C.The mean artery pressure(MAP)and heart race(HR)were recorded before induction(T1),immediately after extubation(T2),and 5 min after extubation(T3);The scoring of cough during extubation was recorded.Sore throat scores were recorded 30 min,1 h,2 h,6 hand24 hafter extubation.Results There was no significant difference in the basic conditions between the two groups.Compared with group A,there was no significant difference in HR and MAP between T and T2 time points in group C;HR at time T3(101.5±13.5 in group A,86.8±11.5 in group C)and MAP(98.8±12.1 in group A and 85.6±11.4 in group C)were lower than group A,P<0.05.The cough score of group C(2.1±0.4)was significantly lower than that of group A(3.4±0.3),P<0.05;the VAS scores of sore throat at 0.5,1,2,6 and 24 hours after extubation were compared.The time review score was significantly lower than that of group A,P<0.05.Conclusion Lidocaine carbonate filled into tracheal intubation airbag can effectively reduce the cardiovascular response of extubation,relieve the incidence of postoperative cough and sore throat.

关 键 词：腹腔镜袖状胃切除术 重度肥胖 碳酸利多卡因 

分 类 号：R614.2[医药卫生—麻醉学]