静脉注射利多卡因联合右美托咪定对全麻下行甲状腺手术患者气管拔管时心血管反应的影响  

Effects of Intravenous Lidocaine Combined with Dexmedetomidine on Cardiovascular Response to Tracheal Extubation in Patients Undergoing Thyroid Surgery under General Anesthesia

作　　者：徐林[1] 喻乐 陈治军 XU Lin;YU Le;CHEN Zhijun(Department of Anesthesiology,Wuhan NO.1 Hospital,Hubei Wuhan 430030,China)

机构地区：[1]武汉市第一医院麻醉科

出　　处：《中国医药导刊》2019年第6期347-351,共5页Chinese Journal of Medicinal Guide

摘　　要：目的:探究静脉注射利多卡因联合右美托咪定对全麻下行甲状腺手术患者气管拔管时心血管反应的影响。方法:随机抽取2017年1~12月于我院气管插管全麻下行甲状腺手术患者120例,随机分为4组,A组(对照组),诱导前大于10min静脉滴注100mL生理盐水,拔管前2min静脉注射2mL生理盐水;B组(右美组),诱导前以1μg·kg^-1剂量右美托咪定稀释至100mL生理盐水,大于10min静脉滴注,拔管前2min静脉注射2mL生理盐水;C组(利多组),诱导前大于10min静脉滴注100mL生理盐水,拔管前2min静脉注射1mg·kg^-1利多卡因;D组(利多联合右美组),诱导前以1μg·kg^-1剂量右美托咪定稀释至100mL生理盐水,大于10min静脉滴注,拔管前2min静脉注射1mg·kg^-1利多卡因。分别观察每组患者入室、手术结束时、拔管时及拔管5min时的心率、血压、呛咳等情况。结果:与A组相比,拔管时B组、C组、D组患者的呛咳反应发生率、心率血压变化幅度均减小,D组患者呛咳发生率更低,血流动力学变化更小。结论:气管插管全麻下行甲状腺手术患者静脉注射利多卡因联合右美托咪定可以有效抑制患者的拔管呛咳反应,并维持血流动力学的平稳。Objective:To explore the effect of intravenous lidocaine combined with dexmedetomidine on cardiovascular response during tracheal extubation in patients undergoing thyroid surgery under general anesthesia.Methods:120 patients undergoing thyroid surgery under tracheal intubation general anesthesia in our hospital from January 2017 to December 2017 were randomly divided into four groups.Group A(control group)was given intravenous drip of 100 mL saline before anesthesia induction more than 10 min,intravenous injection of 2 mL saline 2 minutes before extubation.Group B(dexmedetomidine group),dexmedetomidine was diluted to 100 mL saline at a dose of 1μg·kg-1 for more than 10 min by intravenous drip before anesthesia induction,and intravenous injection of 2 mL saline 2 min before extubation.Group C(lidocaine group),intravenous drip of 100 mL saline more than 10 min before induction,and intravenous injection of 1 mg·kg^-1 lidocaine 2 min before extubation.Group D(lidocaine combined with dexmedetomidine group),dexmedetomidine was diluted to 100 mL saline at a dose of 1μg·kg^-1 for more than 10 min by intravenous drip before induction,and intravenous injection of 1 mg·kg^-1 lidocaine 2 min before extubation.Heart rate,blood pressure and cough were observed at the time of entering the operating room,at the end of the operation,at the time of extubation and 5 min after extubation.Results:Compared with the control group(group A),the incidence of chocking cough and the change of heart rate and blood pressure in group B,C and D decreased,and the incidence of chocking cough and hemodynamic changes decreased more in group D.Conclusion:Intravenous lidocaine combined with dexmedetomidine can effectively inhibit extubation chocking cough response and maintain hemodynamic stability in patients undergoing thyroid surgery under tracheal intubation general anesthesia.

关 键 词：利多卡因 右美托咪定 心血管反应 拔管 

分 类 号：R614.24[医药卫生—麻醉学] R736.1[医药卫生—外科学]