利多卡因联合右美托咪定麻醉对经鼻蝶垂体瘤切除术患者苏醒期拔管时血流动力学指标及呛咳发生率的影响  

Effects of lidocaine combined with dexmedetomidine anesthesia on hemodynamic indexes and incidence of cough during extubation of patients undergoing transsphenoidal pituitary tumor resection

作　　者：张雪东 ZHANG Xue-dong(Department of Anesthesiology,Northern Theater General Hospital,Shenyang 110015,China)

机构地区：[1]北部战区总医院麻醉科,110015

出　　处：《中国现代药物应用》2021年第19期101-104,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究经鼻蝶垂体瘤切除术患者麻醉中联合应用利多卡因与右美托咪定对苏醒期拔管时血流动力学指标及呛咳发生率的影响。方法94例经鼻蝶垂体瘤切除术治疗的患者,采用随机数字表法分为对照组与研究组,各47例。对照组予以右美托咪定麻醉,研究组予以利多卡因+右美托咪定麻醉。比较两组入室时与拔管时的血流动力学指标、呛咳发生率、躁动发生率、术后脑脊液鼻漏发生率、术后疼痛评分。结果拔管时,研究组平均动脉压(72.44±6.21)mm Hg(1 mm Hg=0.133 kPa)、心率(66.96±7.12)次/min均低于对照组的(77.52±6.47)mm Hg、(70.35±9.22)次/min,差异有统计学意义(P<0.05)。研究组呛咳总发生率为2.13%,低于对照组的12.77%,差异有统计学意义(P<0.05)。两组躁动、术后脑脊液鼻漏发生率比较,差异无统计学意义(P>0.05)。术后6、12 h,研究组疼痛评分均低于对照组,差异有统计学意义(P<0.05)。结论利多卡因与右美托咪定联合用于经鼻蝶垂体瘤切除术麻醉中麻醉效果确切,应用价值高。Objective To investigate the effects of lidocaine combined with dexmedetomidine anesthesia on hemodynamic indexes and incidence of cough during extubation of patients undergoing transsphenoidal pituitary tumor resection.Methods A total of 94 patients with transsphenoidal pituitary tumor resection were divided into control group and research group according to random numerical table, with 47 cases in each group. The control group was anesthetized with dexmedetomidine, and the research group was anesthetized with lidocaine and dexmedetomidine. Both groups were compared in terms of hemodynamic index at the time of admission and at the time of extubation, incidence of cough, incidence of agitation, incidence of postoperative cerebrospinal fluid rhinorrhea, and postoperative pain scores. Results At the time of extubation, the mean arterial pressure (72.44±6.21) mm Hg (1 mm Hg=0.133 kPa) and heart rate (66.96±7.12) beats/min of the research group were lower than (77.52±6.47) mm Hg and (70.35±9.22) beats/min of the control group, and the differences were statistically significant (P<0.05). The total incidence of cough in the research group was 2.13%, which was lower than 12.77% in the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the incidence of agitation, incidence of postoperative cerebrospinal fluid rhinorrhea between the two groups (P>0.05). At 6 and 12 h after the surgery, the pain scores of the research group were lower than those of the control group, and the difference was statistically significant (P<0.05). Conclusion Combination of lidocaine and dexmedetomidine has definite anesthesia effect and high application value in the anesthesia of transsphenoidal pituitary tumor resection.

关 键 词：经鼻蝶垂体瘤切除术 利多卡因 右美托咪定 呛咳 

分 类 号：R614[医药卫生—麻醉学]