利多卡因乳膏涂抹气管导管对老年手术患者苏醒期并发症的防治作用  

The effect of lidocaine cream applied on tracheal tube on the prevention of complications during awakening period in elderly patients undergoing surgery

作　　者：曹钟强 高蕾 章一静 许迎华 Cao Zhongqiang;Gao Lei;Zhang Yijing;Xu Yinghua(Department of Anesthesiology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院麻醉科,上海200040

出　　处：《老年医学与保健》2020年第4期688-690,共3页Geriatrics & Health Care

摘　　要：目的观察应用复方利多卡因乳膏后老年全麻患者气管拔管期的应激反应。方法选取2019年1-6月在华东医院住院治疗的ASAⅠ~Ⅲ级的普外科择期需全麻手术老年患者60例,按随机数表法分为试验组和对照组,每组30例。试验组采取复方利多卡因乳膏处理(在气管导管套囊及前部涂抹复方利多卡因乳膏),对照组使用石蜡油润滑处理。两组经相同程序麻醉诱导,随后插入气管导管。记录在诱导前、拔管前、拔管即刻和拔管后1 min患者的生命体征(心率、收缩压、舒张压);同时记录拔管前患者的镇静指数、呛咳发生率、术后1 d有无声嘶和咽喉痛的程度。结果试验组患者在拔管后收缩压和心率均显著低于对照组(P<0.05);试验组患者在拔管后riker评分和咽喉痛的程度均明显低于对照组(P<0.05)。结论使用复方利多卡因乳膏可降低行全麻的老年患者苏醒期的应激反应,减少并发症发生。Objective To observe the stress response of elderly patients with general anesthesia during tracheal extubation after application of compound lidocaine cream. Methods Sixty ASA Ⅰ-Ⅲ elderly patients who received elective general anesthesia for surgical operation in our hospital from January to June 2019 were selected, and they were randomly divided into the experiment group(n=30) and control group(n=30). The experimental group was treated with compound lidocaine cream(smearing compound lidocaine cream on the cuff and front of tracheal tube), while the control group was treated with paraffin oil.The two groups were induced by the same procedure of anesthesia, and then the tracheal tube was inserted. The vital signs(heart rate, systolic blood pressure and diastolic blood pressure) of the patients before induction, before extubation, immediately after extubation and 1 min after extubation were recorded. At the same time, the sedation index, incidence of cough and the degree of silent hoarseness and sore throat 1 day after the operation were recorded and compared between the two groups. Results After the extubation, the systolic blood pressure, heart rate, Riker score and the degree of sore throat of the experimental group were significantly lower than those of the control group(P<0.05). Conclusion The application of compound lidocaine cream can reduce the stress response in the awakening period of elderly patients undergoing general anesthesia and reduce the occurrence of complications.

关 键 词：老年 气管拔管 全身麻醉 复方利多卡因乳膏 应激反应 

分 类 号：R614[医药卫生—麻醉学]