比较盐酸达克罗宁胶浆及利多卡因凝胶作为喉罩润滑剂的临床分析  

Comparison of the Clinical Effects of Dycronine Hydrochloride Muciluge and Lidocaine Gel as Laryngeal Mask Lubricants

作　　者：张宁丽 屈启才[2] 柴璇 段云英 思永玉[2] 张宁平 ZHANG Ning-li;QU Qi-cai;CHAI Xuan;DUAN Yun-ying;SI Yong-yu;ZHANG Ning-ping(Dept. of Anesthesiology,Yunnan Integrated Traditional Chinese and Western Medicine Hospital,Kunming Yunnan 650224;Dept. of Anesthesiology,The Second Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101;Kunming Convalesent Hospital of PLA,Kunming Yunnan 650307,China)

机构地区：[1]云南省中西医结合医院麻醉科,云南昆明650224 [2]昆明医科大学第二附属医院麻醉科,云南昆明650101 [3]中国人民解放军昆明疗养院疗二科,云南昆明650307

出　　处：《昆明医科大学学报》2019年第2期102-105,共4页Journal of Kunming Medical University

基　　金：云南省卫生科技计划项目(2014NS119)

摘　　要：目的观察盐酸达克罗宁胶浆及利多卡因凝胶作为润滑剂对全麻喉罩置入成功率、血流动力学及术后并发症的影响。方法选择择期全麻下行输尿管镜碎石取石术的患者90例,ASAⅠ～Ⅱ级,随机分为3组:生理盐水组(N组)、利多卡因凝胶组(L组)、盐酸达克罗宁胶浆组(D组)。分别用生理盐水、利多卡因凝胶及盐酸达克罗宁胶浆涂抹于喉罩表面,麻醉诱导后插入喉罩。记录麻醉诱导前(T0)、喉罩置入前(T1)、置入即刻(T2)及置入后3 min (T3)患者的收缩压(SBP)、舒张压(DBP)、心率(HR)以及喉罩一次成功置入的时间、一次性成功率、术后24h患者咽部不适、咽痛的发生率等。结果 L组和D组一次成功率明显高于N组(P<0.05),L组和D组一次成功置入的时间明显低于N组(P<0.05);3组患者在T1、T3时刻的SBP、DBP及HR均低于T0,差异有统计学意义(P<0.05),T2时点L组及D组患者SBP、HR高于N组,差异有统计学意义(P<0.05);术后24 h随访患者咽喉不适或咽痛的发生率N组、L组和D组分别为11例、4例和2例(36.7%、13.3%和6.7%),D组最少,差异有统计学意义(P<0.05)。结论使用盐酸达克罗宁胶浆润滑喉罩置入成功率高、置入时间短,术后并发症少。Objective To observe the effects of dyclonine hydrochloride muciluge and lidocaine gel as lubricant and local anesthetics on the success rate,the hemodynamics changes and the postoperative complication of laryngeal mask airway(LMA).Methods Ninety ASAⅠ~Ⅱ patients undergoing ureteroscopic lithotripsy under general anesthesia received insertion of LMA were randomly divided into three groups:normal saline group (group N,n=30),lidocaine gel group (group L,n=30) and dyclonine hydrochloride mucilage group (group D,n=30). We lubricated the surface of LMA with normal saline, lidocaine gel and dyclconine hydrochloride muciluge respectively,and then inserted the LMA after anesthesia induction.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR) were recorded before induction of anesthesia (T0), before laryngeal mask insertion (T1),at LMA insertion (T2) and 3 min after LMA insertion(T3).Time and frequency of LMA insertion,incidence of abnormal sensation of pharynx and sore throat after surgery were recorded.Results The one-time success rate and the insertion time of group L and group D were significantly lower than that of group N(P<0.05).SBP,DBP and HR of the three groups at T1 and T3 were lower than that at T0 (P<0.05).At T2 time point,SBP and HR in group L and group D were lower than that in group N (P<0.05).The incidence of abnormal sensation of pharynx and sore throat was significantly lowest in group D,respectively 36.7%,13.3% and 6.7%(P<0.05).Conclusion Lubricating LMA with dyclonine hydrochloride mucilage has a high success rate, short insertion time,and less postoperative complications.

关 键 词：喉罩 盐酸达克罗宁胶浆 利多卡因凝胶 咽痛 

分 类 号：R614[医药卫生—麻醉学]