利多卡因在小儿气管异物取出术中的应用

Application of Lidocaine of Intravenous Aneasthesia in Operation of Taking Out Eyewinker of Trachea of Children

目的观察在小儿气管异物取出术的麻醉中静脉应用利多卡因是否较咽喉部喷雾更有利于抑制气道反射。方法拟行气管异物取出术的患儿随机分为A、B两组,每组14例,A组为利多卡因静脉组,B组为利多卡因喷雾组,A组诱导期注射咪唑安定0.1mg/kg、利多卡因3mg/kg、芬太尼1.5μg/kg、异丙酚2mg/kg;B组诱导期改利多卡因静注为咽喉部喷雾。麻醉维持以微量输液泵持续输入异丙酚5mg/(kg.h),A组加利多卡因2mg/(kg.h)泵入。观察麻醉诱导后和支气管镜置入气管后MAP、HR、SpO2的变化以及不良反应的发生率。结果①支气管镜置入气管后两组的MAP、HR、SpO2有显著差异(P<0.05)。②支气管镜置入气管后B组屏气、呛咳、气道痉挛的发生率明显高于A组(P<0.05)。结论全凭静脉复合利多卡因麻醉能够更有效的抑制气道反射,使小儿气管异物取出术的麻醉更趋平稳、合理。

Objective To compare the effect of lidocaine in the operation of taking out eyewinker in the trachea of children and lidocaine which was sprayed into throat. Methods 28 cases were divided into two groups randomly which were group A（ n = 14） of intravenous aneasthesia of lidocaine,during the time of inducement, lidocaine 3mg/kg, fentany 1.5 μg,/kg, propofol 2mg/kg and group B（ n = 14） of spray of lidocaine were used. In the time of anesthesia, propofol 5mg/（ kg · h） was used and in group A lidocaine 2mg/（kg ·h） was used as well through the microinfusion. To ob- serve the patients’ difference of MAP, HR,and SpO2 and the rate of happening of side effect during the anesthesia of abduction and the time after bronchiascope was put into trachea. Results ①During the time after bronchia scope was put into trachea, there was significant difference of MAP, HR and SpO2 between the two groups （ P 〈 0. 05 ）. ②During the time after bronchia scope was put into trachea,the rate of happening of holding breath, irritate and spasmodic trachea in group B was more than group A significantly （ P 〈 0. 05 ）. Conclusion Application of lidocanie of intravenous aneasthesia in the operation of taking out eyewinker in the trachea of children could control the reflect of trachea effectively. It made the operation of taking out eyewinker in the trachea of children to be more calm and reasonable.