气管插管前静脉注射利多卡因对减少术后气道症状的效果观察

Intravenous Lidocaine Before Tracheal Intubation for Decreasing the Postoperative Airway Symptoms

[目的]探讨气管插管前静注不同剂量的利多卡因对减少术后气道症状（咽喉痛、咳嗽和咳痰）的效果.[方法]120例在全身麻醉下施行腹腔镜胆囊摘除术的患者,随机将病人分为4组,每组30例 ,分别为对照组（L0组）、利多卡因1组（L1组）、利多卡因2组（L2组）和利多卡因3组（L3组）,在气管插管前分别静注生理盐水0.1 mL/kg、利多卡因0.5 mg/kg、1.0 mg/kg和1.5 mg/kg.[结果]与L0组和L1组比较,麻醉诱导时L2组和L3组的呛咳发生率明显降低（P＜0.01）,术后咽喉痛和咳嗽发生率明显降低（P＜0.01）,程度明显减轻（P＜0.01）,而L2组与L3组比较无明显差异;四组病人的咳痰发生率及其严重程度均无明显不同.[结论]气管插管前静脉注射1.0-1.5 mg/kg利多卡因能降低术后咽喉痛和咳嗽的发生率和严重程度.

[Objective]To investigate whether intravenous lidocaine with different clinical doses before tracheal intubation decreases the incidence of postoperative airway symptoms such as sore throat, cough and expectoration. [Methods] Totally 120 ASA Ⅰ -Ⅱ patients undergoing elective laparoscopic cholecystectomy under general anesthesia were randomized divided into four groups with 30 cases in each group including con trol group（L0 group）, lidocaine Ⅰ group（L1 group）, lidoeaine Ⅱ group（L2 group） and lidociane Ⅲ group（L3 group）. Intravenous normal saline 0. 1ml/kg, lidocaine 0.5mg/kg, 1.0mg/kg and 1.5mg/kg before tracheal intubation were injected respectively. [Results]Compared with L0 group and L1 group, the incidence of cough in L2 group and L3 group at anesthesia induction decreases significantly（ P 〈0.01）. Compared with L0 group and L1 group, the incidence and degree of postoperative score throat and cough in L2 group and L3 group de creased significantly（ P 〈0. 01）, bur there was no significant difference between L2 group and L3 group. There was no significant difference in the incidence and severity of expectoration between four groups. [Conclusionllntravenous lidocainel. 0- 1.5mg/kg before tracheal intubation can decrease the incidence and se verity of postoperative sore throat and cough.