摘要
目的观察体积分数为0.02的利多卡因超声雾化吸入对老年患者全身麻醉诱导中血流动力学变化的影响。方法选择2011年9月―2012年2月于上海交通大学医学院附属新华医院崇明分院择期行中上腹部手术的老年患者60例,美国麻醉医师学会(ASA)分级Ⅰ或Ⅱ级,随机分为对照组、利多卡因静脉组(静脉组)和利多卡因超声雾化吸入组(吸入组),每组20例。观察麻醉诱导前(T0)、气管插管前(T1)以及气管插管后1min(T2)、3min(T3)、5min(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)和脉搏血氧饱和度(SpO2)的变化。结果 3组间的性别构成、年龄、体重及ASA分级构成的差异均无统计学意义(P值均>0.05)。所有患者均在第1次操作获得气管插管成功。与同组T0时间点比较:3组在T1时间点的SBP、DBP均显著降低(P值均<0.05);对照组和吸入组在T1时间点的HR亦显著降低(P值均<0.05)。与同组T1时间点比较:对照组和静脉组在T2、T3和T4时间点的SBP和DBP均显著升高(P值均<0.05);吸入组在T2和T3时间点的SBP和DBP、T4时间点的DBP亦显著升高(P值均<0.05);3组在T2时间点、对照组在T3和T4时间点的HR均显著升高(P值均<0.05)。与对照组同时间点比较:静脉组在T1时间点的DBP显著升高(P<0.05),T2时间点的SBP显著降低(P<0.05);吸入组在T2时间点的SBP、DBP及T3和T4时间点的SBP均显著降低(P值均<0.05)。与静脉组同时间点比较:吸入组在T2时间点的SBP显著降低(P<0.05)。结论体积分数为0.02的利多卡因超声雾化吸入可获得较完善的表面麻醉效果,能明显减轻老年患者全身麻醉气管插管引起的血流动力学变化。
Objective To observe the effect of ultrasonic nebulization of 2% lidocaine on hemodynamics during general anesthesia in elderly patients. Methods Sixty elderly patients （American Society of Anesthesiologists [ASA] grade I or II ） scheduled for epigastric surgery from September 2011 to February 2012 were randomly divided into control group, Iidocaine intravenous injection group, and ultrasonic nebulization group. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） and saturation of blood oxygen （SpO2） were recorded before anesthesia induction （T0）, before intubation （T1）, and at 1 min （T2）, 3 mins （T3） and 5 mins （T4） after intubation. The with failed in whom inbubation at the first time were excluded from statistical analysis. Results There were no significant differences in age, gender, body weight or ASA grade among the three groups （all P〉0.05）. Tracheal intubation was successfully taken in all the patients. Compared with those at T0, SBP and DBP in the three groups and HR in control group and ultrasonic nebulization group at T1 were significantly decreased （all P〈0.05）. Compared with those at T1, SBP and DBP in control group and lidocaine intravenous injection group at T2, T3 and T4, SBP and DBP at T2 and T3 and DBP at T4 in ultrasonic nebulization group, and HR at T2 in three groups and at T3 and T4 in control group were significantly increased （all P〈0.05）. SBP at T2 in lidocaine intravenous injection group, and DBP at T2 and SBP at T2, T3 and T4 in ultrasonic nebulization group were significantly lower that those in control group （all P〈0.05）. DBP at T1 in lidocaine intravenous injection group was significantly higher than that in control group （P〈0.05）. SBP at T2 in ultrasonic nebulization group was significantly lower than that in lidocaine intravenous injection group （P 〈 0. 05）. Conelusion Ultrasonic nebulization with 2% lidocaine can provide enough topical anesthesia, which can relieve hemodynamic re
出处
《上海医学》
CAS
CSCD
北大核心
2012年第12期998-1000,共3页
Shanghai Medical Journal
