利多卡因不同用药方式在鼻骨骨折手术中的效果比较  

Comparison on the efficacy of different administration methods of lidocaine in nasal fracture surgery

作　　者：李紫薇 LI Zi-wei(Anesthesiology department,the affiliated hospital of Xuzhou Medical University,Xuzhou Jiangsu,221000,China)

机构地区：[1]徐州医科大学附属医院麻醉科,江苏徐州221000

出　　处：《齐齐哈尔医学院学报》2021年第11期959-962,共4页Journal of Qiqihar Medical University

摘　　要：目的分析利多卡因喷雾、局部利多卡因注射和利多卡因全身麻醉在鼻骨骨折手术中的应用效果。方法选择2018年1月—2020年1月于本院接受鼻骨骨折复位术的180例患者为研究对象,按照麻醉方式分为A组(60例,利多卡因喷雾)、B组(60例,局部利多卡因注射)和C组(60例,利多卡因联合丙泊酚与瑞芬太尼行全身麻醉)。对比三组患者围术期血流动力学指标变化、术前术后疼痛度变化及各类不良反应的发生率。结果围术期血流动力学指标变化最为平稳的为C组患者,在T_(1)、T_(2)、T_(3)时间点三组平均动脉压(MAP)、心率(HR)和血氧饱合度(SpO_(2))比较,差异具有统计学意义(P<0.05);在围术期疼痛方面,术后30 min和术后1 h时C组VAS疼痛评分最低,其次为B组,A组最高,差异具有统计学意义(P<0.05);在不良反应发生情况方面,C组发生率最高,其次为B组,A组最低,差异具有统计学意义(P<0.05);结论利多卡因不同用药方式能够产生较好的麻醉效果,但局部利多卡因注射同时具有更为稳定的围术期血流动力学指标、更好的镇痛效果及更低的麻醉不良反应发生率,值得临床推广应用。Objective To analyze the effect of lidocaine spray, local lidocaine injection and lidocaine general anesthesia in nasal fracture surgery.Methods 180 patients who underwent nasal fracture reduction surgery in our hospital from January 2018 to January 2020 were selected as the research objects, and they were divided into group A(60 cases, lidocaine spray),group B(60 cases, local lidocaine injection)and group C(60 cases, general anesthesia with lidocaine combined with propofol and remifentanil)according to their choice of anesthesia methods.The changes of perioperative hemodynamic indexes, pain, and incidence of various adverse reactions of the two groups were compared.Results The comparison showed that the most stable hemodynamic changes during the perioperative period were in group C.The differences in mean arterial pressure(MAP),heart rate(HR)and saturation of pulse oxygen(SpO_(2))between the groups were statistically significant at the time point T_(1),T_(2) and T_(3)(P<0.05).In terms of perioperative pain, group C had the lowest VAS score at 30 minutes and 1 hour after surgery, followed by group B,and group A had the highest VAS score(P<0.05).Group C had the highest incidence of adverse reactions, followed by group B Group, Group A is the lowest, the difference was statistically significant(P<0.05).Conclusions Lidocaine could produce good anesthesia effects in different ways of administration, but local lidocaine injection could obtain more stable perioperative hemodynamic indexes, better analgesia effect and lower incidence of adverse reactions induced by anesthesia, it is worthy of clinical application.

关 键 词：利多卡因 喷雾 注射 全身麻醉 鼻骨骨折 

分 类 号：R614[医药卫生—麻醉学]