复方利多卡因乳膏在声带息肉切除手术患者中的应用

Complex lidocaine crem used in polyp of cord resection

目的：探讨复方利多卡因乳膏在声带息肉切除手术患者中使用的有效性和安全性。方法：选取声带息肉切除手术患者40例，随机分为试验组和对照组。试验组使用2g复方利多卡因乳膏涂抹气管导管前1／3，对照组不使用复方利多卡因乳膏，每组各20例患者。记录术前（T1）、插管即刻（T2）、插管后5min（T3）、术毕（T4）、拔管即刻（T5）、拔管后5min（T6）、拔管后10min（T7）各时点的心率（HR）、平均动脉压（MAP）、脉搏血氧饱和度（SpO2）变化，记录术后呛咳反应、异物感、咽喉疼痛等指标变化病例数，局麻药中毒症状。结果：T1～T5各时点HR、MAP、SpO2两组无明显变化，差异无统计学意义（P〉0．05），T6、T7时点试验组HR、MAP显著小于对照组（P〈0．05）；T5时点对照组HR和MAP较试验组显著升高（P〈0．05）；SpO2两组比较无统计学差异（P〉0．05）。试验组术后呛咳例数与对照组无统计学差异（P〉0．05），疼痛程度较对照组轻（P〈0．05），而异物感试验组较对照组重（P〈0．05）。两组利多卡因血药浓度均低于0．5μg／mL。两组均未出现局麻药中毒症状。结论：复方利多卡因乳膏可减轻声带息肉手术拔管刺激，降低术后疼痛程度，增加术后咽喉部异物感，无明显局麻药中毒现象，可安全使用于声带息肉切除手术患者。

AIM： To study the efficacy and safety of complex lidocaine crem used in polyp of cord resection. METHODS： Forty patients who need such operation, were randomly divided to two groups, the trial group and control group. There were 20 patients in each group. The trial group used complex lidocaine crem besmear on the front 1/3 of the tracheal catheter. The control group did not use the drug on the tracheal catheter. The heart rate（HR）, the mean aortic pressure（MAP） and the SpO2 were recorded at beforeoperation（T1） ,just before tracheal intubation（T2）, 5 min after tracheal intubation （T3）, operation eompleteted （T4）, just after extubation （T5）, 5 min after extubation（T6）, 10 min after extubation （T7）. The cases who have bucking, foreign body sensation and throat pain were also recorded, the toxic symptom of local anesthetic was observed. RESULTS. There were no significant differences at T1- T5 between two groups of HR, MAP and SpO2 （P〉0.05） . The HR, MAP in trial group were significantly lower than those in control group at T6 and T7 （P〈0.05） . The HR and MAP were significant higher in control group than those in trial group at T5. The SpO2 had no difference between two groups （P〉 0.05）. There were no significant differences between two groups in the cases who had bucking （P〉0.05）. There were more throat pain patients in control group than in trial group （P〈0.05）. The foreign body sensation patients in experiment group were more than in control group （P〈0.05）. There were no toxic symptom of local anesthetic in all studied patients. CONCLUSION： The complex lidocaine crem used in polyp of cord resection operation can reduce stimulation during extubation, lessen the throat pain after operation. But it can make patient feel the postoperation foreign body sensation. There were no patients emerging toxic symptom of local anesthetic. The complex lidocaine crem can be used in polyp of cord resection efficiently and safely.