复方利多卡因乳膏在舌癌患者眀视鼻插管中的应用

Application of lidocaine-prilocaine cream in patients with tongue cancer during general anesthesia when nasal intubation

目的探讨复方利多卡因乳膏在减轻舌癌患者全麻鼻插管时心血管反应的临床应用。方法 60例ASAⅠ～Ⅱ级拟施鼻插管全麻择期手术患者,按气管插管导管前端用药的不同随机分为两组:液体石蜡油组和复方利多卡因乳膏组。分别记录诱导前(T0)、意识消失(T1)、插管即刻(T2)及插管后3min(T3)时患者的收缩压(SBP)、舒张压(DBP)、心率(HR)。结果液体石蜡油组在T2及T3时间点SBP、DBP、及HR较T0及T1时间点明显增加,差异有统计学意义(P<0.05);而复方利多卡因乳膏组在T2及T3时间点上述指标较T0及T1无显著差异(P>0.05)。组间比较:液体石蜡油组T3时间点SBP、DBP、及HR较复方利多卡因乳膏组明显增加,差异有统计学意义(P<0.05)。结论复方利多卡因乳膏可有效抑制舌癌手术患者气管插管应激反应,维护麻醉诱导期间血流动力学的稳定。

Objective To investigate the clinical effect of lidocaine-prilocaine cream（EMLA） for alleviating cardiovascular response to patient with tongue cancer when nasal intubation.Methods Totally 60 patients of gradeⅠ~Ⅱ of the American Society of Anesthesiologists received the selective operation with general anesthesia were divided into 2 groups with 30 cases in each group according to what the endotracheal tube smeared;They were liquid paraffin group and lidocaine-prilocaine cream（EMLA） group.SBP,DBP and HR were observed on T0（pre-induction）,T1（unconscionsness）,T2（in tubating）,T3（3min after in tubating）.Results When compared with T0 and T1,the SBP,DBP and HR in liquid paraffin group showed obvious increase on T2 and T3（P0.05）;But the lidocaine-prilocaine cream（EMLA） group didn＇t show obvious increase（P0.05）.Group comparison： all the indicators on T3 in the liquid paraffin group were higher than that in the lidocaine-prilocaine cream（EMLA） group,and the difference was statistically significant（P0.05）.Conclusions Lidocaine-prilocaine cream（EMLA） can inhibit the stress response of endotracheal in tubation in tongue cancer surgery,so can maintain hemodynamic stability during general anesthesia.