支气管镜辅助喷洒利多卡因局麻效果评估  

Evaluation of the effect of bronchoscopy assisted lidocaine spraying on local anesthesia

作　　者：于文萱 吴齐[1] 曹长琦[1] YU Wenxuan;WU Qi;CAO Changqi(Endoscopy Center,Peking University Cancer Hospital and Beijing Institute of Cancer Prevention and Treatment,Key Laboratory of the Ministry of Education for Research on the Pathogenesis and Translational Research of Malignant Tumors,Beijing100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所内镜中心,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《社区医学杂志》2024年第2期60-64,共5页Journal Of Community Medicine

摘　　要：目的探讨雾化吸入利多卡因与电子支气管镜辅助喷洒利多卡因在支气管镜检查中的局麻效果比较。方法选取2020-03-01-2021-03-31北京大学肿瘤医院内镜中心拟进行电子支气管镜检查的160例患者为研究对象,分为对照组(80例)和观察组(80例)。对照组采用常规雾化吸入利多卡因进行局部麻醉。观察组采用电子支气管镜辅助一次性使用内镜喷洒管喷洒利多卡因进行局部气道麻醉。比较2组患者1和3min心率、1和3min血氧饱和度、检查时长、呛咳次数、补喷麻药次数、患者疼痛自评分、患者咳嗽自评分、术者咳嗽他评分、术者操作满意度。结果2组患者检查时长、术前心率、1和3min心率、术前血氧饱和度水平、术中补喷麻药次数比较,差异无统计学意义,均P>0.05;观察组1min血氧饱和度为100.0%(99.0%~100.0%),高于对照组的98.0%(96.0%~100.0%),Z=-5.364,P<0.001;3min血氧饱和度为99.5%(98.0%~100.0%),高于对照组的98.0%(96.0%~100.0%),差异有统计学意义,Z=-4.199,P<0.001;术中呛咳次数为6.5(3.0~10.0)次,低于对照组的12.0(8.0~20.0),差异有统计学意义,Z=-4.457,P<0.001。观察组患者疼痛自评分为2(1~3)分,低于对照组的5(3~7)分,差异有统计学意义,Z=-5.857,P<0.001;咳嗽自评分为30(20~46)分,低于对照组的50(40~70)分,差异有统计学意义,Z=-5.140,P<0.001;术者咳嗽他评分为20(10~30)分,低于对照组的50(40~70)分,差异有统计学意义,Z=-5.966,P<0.001。观察组术者操作满意度为80%(70%~90%),高于对照组的50%(30%~60%),差异有统计学意义,Z=-6.001,P<0.001。对照组有8例患者出现手麻症状,立即停止患者吸入雾化吸入,指导减慢呼吸频率,症状缓解消失。所有患者均未见利多卡因相关不良反应。结论电子支气管镜辅助一次性使用内镜喷洒管喷洒利多卡因表面麻醉效果优于雾化吸入利多卡因。Objective To compare the effect of local anesthesia between aerosol inhalation of lidocaine and electronic bronchoscopy assisted spraying of lidocaine in electronic bronchoscopy.Methods Totally 160patients who were scheduled to undergo electronic bronchoscopy from March 1,2020to March 31,2021in the Endoscopy Center of Peking University Cancer Hospital were selected as the study subjects,and divided into the control group(80persons)and the experimental group(80persons).The control group received local anesthesia using conventional nebulized inhalation of lidocaine.The experimental group used electronic bronchoscopy assisted disposable endoscopic spray tube to spray lidocaine for local airway anesthesia.The heart rate,oxygen saturation,duration of examination,times of choking,times of supplementary anesthesia spraying,patient's pain self score,patient's cough self score,operator's cough other score,and operator's operation satisfaction were compared between the two groups.Results There was no significant difference in the length of examination,preoperative heart rate,1-and 3-min heart rate,preoperative blood oxygen level,and the number of times of supplementary spraying of anesthesia during the operation in the two groups,all of which were P>0.05.The 1-min blood oxygen concentration in the observation group was 100.0%(99.0%-100.0%),which was higher than that in the control group,which was 98.0%(96.0%-100.0%),with Z=-5.364,and P<0.001,and the 3-min blood oxygen concentration was 99.5%(98.0%-100.0%),which was higher than that in the control group,which was 98.0%(96.0%-100.0%),with Z=-4.199,and P<0.001;the number of intraoperative choking coughs was 6.5(3.0-10.0)times,lower than that of 12.0(8.0-20.0)in the control group,Z=-4.457,P<0.001;the pain self-rating score was 2(1-3),lower than 5(3-7)in the control group,Z=-5.857,P<0.001;and the operator's score for cough was 20(10-30),lower than the control group's 50(40-70)points,Z=-5.966,P<0.001.The satisfaction rate of the observation group was 80%(70%-90%),which was highe

关 键 词：电子支气管镜 一次性使用内镜喷洒导管 利多卡因注射液 麻醉 

分 类 号：R614[医药卫生—麻醉学]