摘要
目的探讨利多卡因咽部表面麻醉对老年患者双腔气管插管血流动力学的影响.方法选择ASAI^II级行全麻双腔气管插管的老年患者60例,随机分为两组,每组30例,于气管插管前观察组(L组)给予2%利多卡因3ml行咽部表面麻醉,对照组(D组)给予0.9%氯化钠液喷洒咽部作为对比.观察麻醉诱导前(T0)、气管插管前(T1)、插管后1min(T2)、3min(T3)及5min(T4)时平均动脉压(MAP)、心率(HR)变化.结果两组MAP、HR在T0时差异无统计学意义(P>0.05),T1时,两组MAP、HR与T0时比较均下降(P<0.05).D组:MAP在T2、T3、T4时与T1时比较均升高(P<0.05),与T0时比较差异无统计学意义(P>0.05);而HR在T2、T3时与T0、T1比较均升高(P<0.05),T4时有所下降.L组:MAP、HR在T2、T3、T4时与T0时比较均明显降低(P<0.05),但与T1时比较差异无统计学意义(P>0.05),并且各时间点与D组比较差异均有统计学意义(P<0.05);L组呛咳率、恶心呕吐率均低于D组,差异有统计学意义(P<0.05);L组躁动率与D组差异无统计学意义(P>0.05);L组麻醉方法评价优良率高于D组,差异有统计学意义(P<0.05).结论采用2%利多卡因对老年患者咽部进行表面麻醉,可以明显减轻老年患者双腔气管插管引起的血流动力学变化,减少气管插管引起的不良反应.
Objective To investigate the effect of lidocaine pharyngeal surface anesthesia on hemodynamies of double-lumen endotracheal intubation in elderly patients.Method Sixty elderly patients with dual-cavity endotracheal intubation under general anesthesia(ASAⅠ-Ⅱ)were selected.They were randomly divided into two groups,n=30,before endotracheal intubation,observation group(L group)was given 2%lidocaine 3ml for pharyngeal surface anesthesia,and control group(group D)was given 0.9%sodium chloride solution spraying pharynx for comparison.The changes of mean arterial pressure(MAP)and heart rate(HR)of before anesthesia induction(TO),before endotracheal intubation(T1)and 1min(T2)、3min(T3)、5min(T4)after endotracheal intubation were observed.Result There was no statistically significant difference in MAP and HR between the two groups at TO(P>0.05).MAP and HR in both groups decreased at T1(P<0.05).In group D,MAP was significantly increased at T2,T3,T4 compare with Tl(P<0.05),but the difference was not statistically significant with TO(P>0.05);And compared with T0 and TI,HR was significantly increased at T2 and T3(P<0.05),but decreased at T4.In group L,MAP and HR were significantly lower atT2,T3andT4thanatT0(P<0.05),butthe differences were not statistically significant compared with T1(P>0.05),and the differences were statistically significant at each time point compared with group D(P<0.05)..The choking rate and nausea and vomiting rate of group L were lower than that of group D,the difference was statistically significant(P<0.05);the agitation rate of group L was not statistically different from that of group D(P>0.05);the anesthesia method evaluation of group L was excellent The rate was higher than that in group D,and the difference was statistically significant(P<0.05).Conc lus ion Topical anesthesia with 2%lidocaine on the pharynx of elderly patients can significantly reduce the hemodynamic changes caused by dual-chamber endotracheal intubation and reduce the adverse reactions caused by endotracheal intubation.
作者
廖飞
陈静宜
陈粤丽
朱雁鸿
Liao Fei;Chen Jingyi;Chen Yueli;Zhu Yanhong(Department of Anesthesiology,the sixth affiliated Hospital of Kunming Medical University and the people's Hospital of Yuxi City,Yunnan Prov ince,653100)
出处
《首都食品与医药》
2020年第22期81-83,共3页
Capital Food Medicine
关键词
利多卡因
表面麻醉
老年
双腔气管插管
血流动力学
Lidocaine
Topical anesthesia
EIderly patients
Double-chamber en ndotracheal intubation
hemody namics
