摘要
目的探讨利多卡因不同给药方式在甲状腺手术全身麻醉(全麻)中的应用。方法 72例甲状腺手术患者,随机分为实验A组、实验B组和对照组,各24例。三组患者均使用丙泊酚+瑞芬太尼复合麻醉,实验A组在麻醉前用利多卡因缓慢静脉注射进行麻醉前诱导,并在术中使用利多卡因维持;实验B组在麻醉诱导后,气管插管前应用利多卡因气管内喷雾。对照组采用常规麻醉方法。比较三组患者苏醒时间及拔管时间,拔管前、后5 min的镇静-躁动评分(SAS),拔管后30 min的疼痛视觉模拟评分法(VAS)评分,曲马多用量,呛咳程度等。结果三组患者苏醒时间和拔管时间比较差异无统计学意义(P>0.05)。拔管前、后5 min,实验A组和实验B组的SAS评分均低于对照组,差异具有统计学意义(P<0.05)。实验A组的拔管后30 min VAS评分为(1.62±0.82)分,曲马多用量为(0.23±0.34)mg/kg;实验B组分别为(1.53±0.75)分、(0.20±0.27)mg/kg;对照组分别为(2.64±1.24)分、(0.63±0.43)mg/kg。实验A组与实验B组拔管后30 min VAS评分低于对照组,曲马多用量少于对照组,差异具有统计学意义(P<0.05)。实验A组和实验B组的呛咳评分比较差异无统计学意义(P>0.05);实验A组和实验B组的呛咳评分明显低于对照组,差异具有统计学意义(P<0.05)。结论在甲状腺全麻手术中,麻醉前缓慢静脉注射并术中维持给予利多卡因与麻醉诱导后、气管插管前给予利多卡因麻能够明显增加麻醉效果,且能减少镇痛药曲马多的使用,减少术后躁动,值得临床推广。
Objective To investigate application of lidocaine by different administration ways in general anesthesia for thyroid operation.Methods A total of72patients receiving thyroid operation were randomly divided into experimental A group,experimental B group,and control group,with24cases in each group.All three groups received propofol+remifentanil for combined anesthesia.The experimental A group received lidocaine by slow intravenous injection for anesthesia induction,followed by intraoperative maintenance by lidocaine.The experimental B group received endotracheal spray of lidocaine after anesthesia induction and before tracheal intubation.The control group received conventional anesthesia way.Comparison was made on recovery time,extubation time,sedation-agitation scale(SAS)before and in5min after extubation,visual analogue scale(VAS)score in30min after extubation,tramadol dosage and irritating cough degree in the three groups.Results There was no statistically significant difference of recovery time and extubation time in the three groups(P>0.05).Before and in5min after extubation,the experimental A and B groups both had lower SAS score than the control group,and the difference had statistical significance(P<0.05).The experimental A group had VAS score in30min after extubation as(1.62±0.82)points,and tramadol dosage as(0.23±0.34)mg/kg,which were respectively(1.53±0.75)points and(0.20±0.27)mg/kg in the experimental B group,and(2.64±1.24)points,(0.63±0.43)mg/kg in the control group.The experimental A and B groups had lower VAS scores in30min after extubation and less tramadol dosage than the control group,and the difference had statistical significance(P<0.05).There was no statistically significant difference of irritating cough score between the experimental A group and the experimental B group(P>0.05),while the experimental A and B groups had obviously lower irritating cough score than the control group,and their difference had statistical significance(P<0.05).Conclusion In general anaesthesia thyroid operatio
作者
王宇恒
焦晶华
李明选
孙晓峰
WANG Yu-heng;JIAO Jing-hua;LI Ming-xuan(Department of Anesthesiology, Central Affiliated Hospital of Shenyang Medical College, Shenyang 110024, China)
出处
《中国现代药物应用》
2017年第8期95-97,共3页
Chinese Journal of Modern Drug Application
关键词
利多卡因
甲状腺手术
麻醉恢复期
Lidocaine
Thyroid operation
Anesthesia recovery period
