复方利多卡因乳膏涂抹气管导管预防全身麻醉患者体位变换时血流动力学改变

Clinical observation of haemodynamics varieties to Lidocaine-Prilocaine cream endotracheal topical anesthesia preventing from operation position changing after general anesthesia

目的探讨复方利多卡因乳膏涂抹气管导管预防全身麻醉患者体位变换时血流动力学变化的临床可行性。方法择期行泌尿外科经皮肾镜碎石术(PCNL)60例,ASAⅠ、Ⅱ级,男38例,女22例,年龄35～68岁,随机分为两组。实验组在麻醉诱导插管前将复方利多卡因乳膏2～3g涂抹于气管导管前端,对照组不用。观察并记录两组患者在术中截石位(T1)、俯卧位(T2)、术毕仰卧位(T3)、拔管时(T4)的血流动力学变化,并与麻醉诱导前(T0)比较。结果对照组在术中截石位(T1)、俯卧位(T2)、术毕仰卧位(T3)、拔管时(T4)的收缩压、舒张压、心率、心率收缩压乘积值均明显高于复方利多卡因乳膏实验组(P<0.05)。结论复方利多卡因乳膏气管表面麻醉可预防全身麻醉患者手术体位变换时气管导管对气管表面黏膜刺激引起的血流动力学反应。

[Objective] To evaluate haemodynamics varieties to Lidocai,ne-Prilocaine Cream endotracheal topical anesthesia preventing from operation position changing after general anesthesia. [Methods] Sixty ASA Ⅰ - Ⅱ patients （male 38, female 22, age 35-68） undergoing pereutaneous nephrostolithotomy were randomly divided into two groups with 30 cases each. Trial group smeared evenly Lidocaine-Prilocaine cream 2-3 g over trachel tube before anesthesia induction. Observing two group＇s varieties with SBP, DBP, HR, RPP in lithotomy position, prone position ,supine position （operation ending）, extubation and compared with prior anesthesia induction. [Result] Haemodynamic response significant increased in control group during operation position changing and extubation, （P 〈0.05）. [Conclusions] Lidocaine-Priloeaine cream endotracheal topical anesthesia could prevent cadiovaseular reactions from operation position changing after general anesthesia.