复方利多卡因乳膏在全身麻醉胃减容术苏醒期中的作用研究

摘要
图/表
参考文献(16)
相关文章 (2)

全文: PDF (0 KB) HTML (37 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨复方利多卡因乳膏在全身麻醉胃减容术苏醒中的作用。方法选取2015年10月～2016年3月在我院择期行全身麻醉下腹腔镜胃减容术的60例患者作为研究对象，BMI为35～58.5 kg/m2。将入选患者随机分为L组（复方利多卡因乳膏组）和C组（对照组），各30例。L组气管导管前1/3涂抹1.0～1.5 g复方利多卡因乳膏，C组气管导管表面不涂任何药物。比较两组麻醉前（T0）、拔管前1min（T1）、拔管即刻（T2）、拔管后1min（T3）、拔管后3min（T4）、拔管后5min（T5）的平均动脉压（MAP）、心率（HR）、血氧饱和度（SpO2）水平，记录两组苏醒拔管过程中的屏气、呛咳和烦躁发生情况。结果C组T1～T5各时间点的MAP和HR值高于T0时间点值，差异有统计学意义（P＜0.05）；T3～T5时间点的SpO2值低于T0时间点值，差异有统计学意义（P＜0.05）。L组T1～T5各时间点的MAP、HR和SpO2值与T0时间点值比较，差异无统计学意义（P＞0.05）。L组T1～T5各时间点的MAP和HR值显著低于C组对应时间点值，差异有统计学意义（P＜0.05）；T3～T5时间点的SpO2值高于C组对应时间点值，差异有统计学意义（P＜0.05）。L组的呛咳、屏气、躁动等不良反应发生率低于C组，差异有统计学意义（P＜0.05）。结论复方利多卡因乳膏涂抹于气管导管外壁可有效抑制全身麻醉胃减容术苏醒期气管导管的刺激，使患者平稳度过苏醒拔管期。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	鲁婷
	魏国华
	沈健

关键词 ：复方利多卡因乳膏, 胃减容术, 气管拔管, 心血管反应

Abstract：ObjectiveTo explore the effect of Compound Lidocaine Cream in the recovery period of general anesthesia for gastric reduction surgery.Methods60 patients underwent selective gastric reduction surgery under general anesthesia from October 2015 to March 2016 in our hospital were selected as the research subjects,the body mass index was 35-58.5 kg/m2.All patientswere randomly divided into group L (Compound Lidocaine Cream group)and group C(the control group),30 cases in each group.The first 1/3 tracheal catheter in group L was applied with 1.0-1.5 g Compound Lidocaine Cream,while,nomedication was applied to the tracheal catheter in group C.The level ofmean arterial pressure(MAP),heart rate(HR)and oxygen saturation(SpO2)before anesthesia(T0),1 min before extubation(T1),extubation (T2),1 min after extubation(T3),3 min after extubation(T4),5 min after extubation(T5)in the two groupswere compared, the incidence rate of cough reflex,breath holding and restlessness during extubation in the two groups were recorded.ResultsThe level of MAP and HR in group C at T1-T5was higher than that at T0,with significant difference (P＜0.05). The level of SpO2in group C at T3-T5was lower than that at T0,with significant difference(P＜0.05).There was no significant difference in the level of MAP,HR and SpO2in group L between T1-T5and T0(P＞0.05).The level of MAP and HR in group L at T1-T5was lower than that in group C at T1-T5,with significant difference (P＜0.05).The level of SpO2in group L at T3-T5was higher than that in group C at T3-T5,with significant difference (P＜0.05).The incidence rate ofcough reflex,breath holding and restlessness during extubation in group L was lower than that in group C,with significant difference (P＜0.05).ConclusionApplication of Compound Lidocaine Cream applied to the outer wall of the tracheal catheter can effectively inhibit the stimulation of tracheal catheter in the recovery period of general anesthesia for gastric reduction surgery,make the patient get through the recovery and extubation period smoothly.

Key words： Compound Lidocaine Cream Gastric reduction surgery Tracheal extubation Cardiovascular response

引用本文:

鲁婷；魏国华；沈健. 复方利多卡因乳膏在全身麻醉胃减容术苏醒期中的作用研究[J]. 中国当代医药, 2016, 23(34): 117-119.
LU Ting； WEIGuo-hua ；SHEN Jian. Effect study of Com pound Lidocaine Cream in the recovery period of general anesthesia for gastric reduction surgery. 中国当代医药, 2016, 23(34): 117-119.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2016/V23/I34/117

[3]	程凯军，沈泳坚，董章利.脑电双频指数结合异丙酚靶控输注在全麻拔管中的应用[J].临床和实验医学杂志，2006，5（11）：1683.
[4]	陈华，姚国华.复方利多卡因预防气管插管及拔管应激反应的临床观察[J].药物与临床，2009，6（28）：62-64.
[5]	杨静，代光莉.恩纳乳膏气管导管表面涂布行表面麻醉的临床观察[J].临床麻醉学杂志，2004，20（7）：427-429.
[6]	魏玉洁，张卫，吕东东.复方利多卡因乳膏在气管插管全麻中的应用[J].医学信息（手术学分册），2008，21（4）：327-328.
[7]	Leme Silva P，Pelosi P，Rocco PR，et al.Mechanical ventilation in obese patients[J].Minerva Anestesiol，2012，78（10）：1136-1145.
[11]	刘俊杰，赵俊.现代麻醉学[M].北京：人民卫生出版社，1987：499.
[12]	李英，张忠山，张灿英.全身麻醉苏醒期拔管时心血管的反应及防治[J].海南医学，2005，16（2）：108-109.
[14]	张国智，王晓，魏新川，等.恩纳乳膏气管导管表面涂布行气管黏膜表面麻醉的可行性[J].中华麻醉学杂志，2003，23（7）：548-550.
[16]	贾瑞芳，谭玲，徐宏伟.恩纳对小儿气管导管耐受性的影响[J].中华麻醉学杂志，2003，23（9）：708-709.
[1]	Bickelmann AG，Burwell CS，Robin ED，et al.Extreme obesity associated with alveolar hypoventilation：a pickwickian syndrome[J].Am JMed，1956，21（5）：811-818.
[2]	Iyer US，Koh KF，Chia NC，et al.Perioperative risk factors in obese patients forbariatric surgery：a Singapore experience[J]. Singapore Med，2011，52（2）：94-99.
[8]	Gaszynski T，Szewczyk T.The influence of laparoscopic vs. open gastric bypass on hemodynamic function in morbidly obese patients during general anesthesia[J].Wideochir Inne Tech Malo Inwazyjne，2014，9（1）：83-88.
[9]	Marashi SM，Ghafari MH，Saliminia A.Attenuation of hemodynamic responses following laryngoscopy and tracheal intubation comparative assessment of clonidine and gabapentin premedication[J].Middle East JAnesthesiol，2009，20（2）：233-237.
[10]	Larijani GE，Cypel D，Gratz I，et al.The efficacy and safety of EMLA cream for awake fiberoptic endotracheal intubation[J].Anesth Analg，2000，91（8）：1024-1026.
[13]	Estebe JP，Delahaye S，Le Corre P，et al.Alkal ionization of intracuf lidocaine and use of lubdcation protecta against tracheal tube induced emergencephenomena[J].Br JAnaesth，2004，92（3）：361-366.
[15]	Fusun E，Aysegul U，Erol E.The analgesic effect of EMLA cream on sore throat following tracheal intubation[J].Pain Clin，2002，14（1）：85-88.