异丙酚靶控输注联合利多卡因滴入和雾化吸入在保留自主呼吸下气管插管中的应用

Application of Propofol Target-controlled Infusion Combined with Dribbled and Nebulized Lidocaine in Tracheal Intubation under Spontaneous Respiration

目的评估异丙酚靶控输注联合利多卡因滴入和雾化吸入在保留自主呼吸下气管插管中的应用价值。方法以40例拟行全身麻醉下气管插管的择期手术患者为研究对象,在异丙酚靶控输注联合利多卡因滴入和雾化吸入条件下实施气管插管,并随机分为完整气管插管组(n=20)和部分气管插管组(n=20)两组,分别将气管导管插至声门下6～8cm和3～4cm处。结果所有患者血流动力学稳定,均在自主呼吸状态下顺利完成气管插管,未发生严重呼吸道并发症。完整气管插管组和部分气管插管组患者的咳嗽反应发生率分别为55%(11/20)和0,两组间差异有统计学意义(P<0.01)。结论异丙酚靶控输注联合利多卡因滴入和雾化吸入可在患者无意识和自主呼吸状态下为气管插管提供良好条件,部分气管插管能有效预防咳嗽反应的发生。

Objective To evaluate the value of propofol target-controlled infusion combined with dribbled and nebulized lidocaine in tracheal intubation under spontaneous breathing.Methods Totally 40 elective surgery patients to accept tracheal intubation under unconsciousness and spontaneous breathing were randomly divided into 2 groups：6-8 cm of endotracheal tube was inserted subglottically in the complete intubation group（n=20）while 3-4 cm was inserted temporarily in the partial intubation group（n=20）.Results The tracheal intubation was successfully completed under spontaneous breathing in all patients;meanwhile,the hemodynamic status was stable without any severe respiratory complications.Eleven patients suffered from moderate coughing response in the complete intubation group while no such response was noted in the partial intubation group（P〈0.01）.Conclusions Application of propofol target-controlled infusion combined with dribbled and nebulized lidocaine provides a good condition for tracheal intubation under unconsciousness and spontaneous breathing.The partial intubation can effectively prevent the occurence of coughing response.