不同表面麻醉方式对全麻插管应激反应及导管耐受性影响的研究

Influence of Different Surface Anesthesia on Stress Reaction during induction and Tolerance of Tube during Recovery

目的：观察咽喉粘膜表面麻醉、气管粘膜表面麻醉、导管外涂乳膏表面麻醉三种不同方式的应用．对全麻插管应激反应及耐管性影响的临床研究。方法选取90例ASA Ⅰ～Ⅱ级择期全麻手术气管插管病人。随机分为三组（n=30）．A组为三重表麻组．B组为双重表麻组、C组为对照组。记录三组在喉镜显露声门即刻（To）．插管后1min（T1）、3min（T2）．5min（T3）的平均动脉压（MAP）和心率（HR）数值以及意识恢复后。患者对导管的耐受程度。结果：同对照组比较．三重表麻组和双重表麻组的MAP和HR均明晁低于对照组（P〈0．01）。在耐管性方面，三重表麻组明显高于双重表麻组和对照组（P〈0．05）。结论：三种表麻方法序贯应用能有效预防喉镜置入和气管插管引起的心血管应激反应，并明显提高导管耐受程度。

Objective： Three ways of surface anesthesia：Throat mucosa, trachea mucosa, and Emulsifiable paste, which applied in general anesthestia with different combination, to investigate the influence on stress reaction during induction and also the tolerance of tube during recovery. Methods： 90 ASAI-II patients with general anesthesia were randomly divided into 3 groups（n=30）：A： apply with all three surface anesthesia; B： Throat and trachea mucosa surface anesthesia; C： Control, without any anesthesia. Recorded the mean blood pressure（MAP）and heart rate（HR） at intubation （TO） , 1 rain （T1） , 3min （T2） , 5min （T3） after intubation, as well as the tolerance of tube after recovery. Rusults： Compared with Control group, MAP and HR in A and B groups were much lower （P〈0.01） . A group had the highest tolerance of tube than group B and C （P〈0.05） . Conclusion： Combination with all three surface anesthesia can effectively prevent the stress reaction of intubation, and increase the tolerance of the tube.