摘要
目的比较在气管拔管时利多卡因通过两种不同给药方式所能预防拔管引起的呛咳的效果对比以及对心率血压的影响。方法选取本院接受气管插管全麻患者90例,按照随机分配的方法,将其分为对照组(A组)静脉注射利多卡因组(B组),气管内注射利多卡因组(C组),各30例。A组采取术后静注5 mL生理盐水,B组采取术后2%利多卡因1.5 mg/kg静脉注射,C组采取术后经气管导管注射2%利多卡因1.5 mg/kg。比较三组麻醉入室时心率血压(T1),拔管时心率血压(T2),拔管后五分钟心率血压(T3);拔管时呛咳反射程度。结果三组患者性别、年龄、体质量指数、ASA分级无统计学意义(P>0.05),三组患者拔管期间呛咳情况及呛咳分级的比较A组患者发生呛咳的程度及概率显著大于B组及C组,差别有统计学意义(P<0.05),B组发生呛咳的程度及概率要大于C组,差别具有统计学意义(P<0.05),三组患者拔管期间心率评价动脉压(MAP)比较在T1时刻,三组间心率及血压不具有统计学意义(P>0.05)差异无显著性,T2及T3时刻A组心率及血压变化显著强于B组及C组差别具有统计学意义(P<0.05),T2时刻B组较C组心率血压略有上升但弱于A组,差别具有统计学意义(P<0.05),T3时刻B组及C组心率及血压差别无统计学意义(P>0.05)差异无显著性。结论静脉注射与气管内注射2%利多卡因都能起到减轻呛咳维持血流动力学稳定的作用,其中气管内注射减轻呛咳程度优于静脉内用药。
Objective To compare the effects of lidocaine on preventing cough caused by extubation and its hemodynamic effects during extubation by two different modes of administration.Methods Ninety patients from our hospital who underwent tracheal intubation under general anesthesia were selected and randomly divided into the control group(group A)group of intravenous lidocaine(group B)and intratracheal injection of lidocaine group(Group C),30 cases each.In group A,5 mL of physiological saline was intravenously injected,in group B,2%lidocaine 1.5 mg/kg was injected intravenously after operation,and in group C,2%lidocaine 1.5 mg/kg was injected intratracheally.The heart rate and blood pressure(T1)of the three groups during anesthesia were compared,and the heart rate and blood pressure(T2)at the time of extubation,and the heart rate and blood pressure(T3)fi ve minutes after extubation were compared.Results There was no signifi cant difference in gender,age,body mass index,and ASA classifi cation among the three groups(P>0.05).The cough status and cough classifi cation during extubation in the three groups were signifi cantly different.Larger than group B and group C,the difference was statistically signifi cant(P<0.05).The degree and probability of coughing in group B was greater than that of group C,the difference was statistically signifi cant(P<0.05).Heart rate during extubation in the three groups of patients Comparing the evaluation of arterial pressure(MAP)At time T1,there was no signifi cant difference in heart rate and blood pressure between the three groups(P>0.05).There was no signifi cant difference in heart rate and blood pressure between group A and group B at time T2 and T3.The difference was statistically signifi cant(P<0.05).At time T2,the heart rate and blood pressure of group B increased slightly but were weaker than that of group A.The difference was statistically signifi cant(P<0.05).At time T3,the heart rate and blood pressure of group B and group C The difference was not statistically signifi cant(P>0.
作者
顾竹劼
马钰
汪建胜
GU Zhu-jie;MA Yu;WANG Jian-sheng(Department of Anesthesiology,Shanghai Baoshan District Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai 201999,China)
出处
《中国医药指南》
2020年第18期74-75,共2页
Guide of China Medicine
关键词
利多卡因
拔管
呛咳反应
气管内注射
静脉注射
Lidocaine
Cough response
Intratracheal injection
Intravenous injection
