利多卡因超声雾化吸入联合导管涂布对双腔支气管导管插管和拔管时血流动力学的影响  

Effect of lidocaine ultrasonic atomization inhalation combined with catheter coating on hemodynamics of double lumen bronchial catheter intubation and extubation

作　　者：徐海丽 郭慧 张鑫磊 刘功俭 孔明健 XU Haii;GUO Hui;ZHANG Xinei;LIU Gongjian;KONG Mingjian(Department of Anesthesiology,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Anesthesiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002)

机构地区：[1]徐州医科大学第二附属医院麻醉科,江苏徐州221000 [2]徐州医科大学附属医院麻醉科,江苏徐州221002

出　　处：《徐州医科大学学报》2023年第12期906-910,共5页Journal of Xuzhou Medical University

基　　金：国家自然科学基金面上项目(81371210);徐州市科技局基金(KC201219);徐州市卫生健康委青年医学科技创新项目(XWKYHT20210538)。

摘　　要：目的探讨利多卡因超声雾化吸入联合复方利多卡因乳膏双腔管涂布对双腔支气管导管插管和拔管时血流动力学的影响。方法选择徐州医科大学第二附属医院择期行胸腔镜下肺叶切除术的患者120例,随机分为生理盐水雾化组(N组)、利多卡因雾化组(L组)、利多卡因雾化联合利多卡因乳膏涂布组(LL组),每组40例。N组在麻醉前30 min雾化吸入10 ml生理盐水,L组在麻醉前30 min超声雾化吸入2%利多卡因10 ml,LL组在麻醉前30 min超声雾化吸入利多卡因,在双腔管前端涂布利多卡因乳膏。记录插管前(T0)、插管即刻(T1)、插管后1 min(T2)、插管后3 min(T3)、手术结束时(T4)、气管拔管即刻(T5)、拔管后1 min(T6)、拔管后3 min(T7)患者的平均动脉压(MAP)、心率(HR)。记录气管拔管期间患者的呛咳评分、咽痛评分及其他不良反应。结果与N组比较,L组和LL组在T1、T2时间点MAP、HR明显降低(P<0.017),L组和LL组间比较差异无统计学意义(P>0.017)。与N组和L组比较,LL组在T5、T6时间点MAP、HR明显降低(P<0.017),N组与L组间比较差异无统计学意义(P>0.017)。LL组呛咳评分和咽痛评分均低于N组和L组(P<0.017),N组和L组比较呛咳和咽痛评分差异均无统计学意义(P>0.017)。结论利多卡因超声雾化吸入联合利多卡因乳膏涂布可抑制双腔支气管导管插管和拔管时血流动力学波动,降低术后呛咳和咽痛的发生率,提高患者麻醉舒适度,不增加术后反流误吸风险。Objective To investigate the effect of lidocaine ultrasonic nebulization inhalation combined with com-pound lidocaine cream double lumen tube coating on hemodynamics during double lumen bronchial tube intubation and extubation.Methods A total of 120 patients who underwent selective thoracoscopic lobectomy at the second Affiliated Hospital of Xuzhou Medical University were randomly divided into 3 groups:saline nebulization group(Group N),lido-caine nebulization group(Group L),lidocaine spray inhalation combined with lidocaine cream group(Group LL),with 40 patients in each group.The N group nebulized 10 ml of saline 30 minutes before anesthesia,the L group nebulized 10 ml of 2%lidocaine 30 minutes before anesthesia,and the LL group nebulized lidocaine 30 minutes before anesthesia,and lidocaine cream was applied to the front end of the double-lumen tube.The mean arterial pressure(MAP)and heart rate(HR)were recorded at various time points:before intubation(T0),immediately after intubation(T1),1 minute after intubation(T2),3 minutes after intubation(T3),at the end of surgery(T4),immediately after tracheal extubation(T5),1 minute after extubation(T6),and 3 minutes after extubation(T7).Cough score and pharyngeal pain score as well as other adverse reactions were recorded during tracheal extubation.Results Compared with the N group,the MAP and HR of the L and LL groups were significantly reduced at time points T1 and T2(P<0.017),while there was no sta-tistical difference between the L and LL groups(P>0.017).Compared with the N and L groups,the LL group showed a significant decrease in MAP and HR at the T5 and T6 time points(P<0.017),while there was no statistical difference between the N and L groups(P>0.017).The cough and pharyngeal pain scores in the LL group were lower than those in the N and L groups(P<0.017),with no statistically significant difference in cough and pharyngeal pain scores between the N and L groups(P>0.017).Conclusions Lidocaine ultrasonic nebulization combined with lidocaine cream coating can reduce

关 键 词：利多卡因 超声雾化 导管涂布 表面麻醉 双腔气管插管 血流动力学 

分 类 号：R614.32[医药卫生—麻醉学]