全麻下鼻窦开放术后拔管期间防止呛咳的研究

Study on the prevention of irritating cough during extubation after sinus surgery under general anesthesia

目的探讨预防全麻下鼻窦开放术后拔管期间呛咳的方法。方法选取2011年1月~2月于本院进行全麻下鼻窦开放术治疗的140例患者为研究对象,随机分为A组和B组各70例,A组术毕前导管内注入利多卡因,B组术毕前导管内注入丁卡因,后将两组患者呛咳发生率及拔管前5 min、拔管后即刻、拔管后5 min的HR、MAP、SBP、DBP、BIS及血糖、皮质醇、β内啡肽水平进行统计及比较。结果 B组呛咳发生率低于A组,B组HR、MAP、SBP、DBP、BIS及血糖、皮质醇、β内啡肽水平波动幅度均小于A组,P均〈0.05,差异均有统计学意义。结论丁卡因在预防全麻下鼻窦开放术后拔管期间呛咳中的效果更好,患者的应激反应更轻。

Objective To study the method of preventing irritating cough during extubation after sinus surgery under general anesthesia.Methods 140 patients treated with sinus surgery under general anesthesia in our hospital from January 2009 to July 2011 were selected.The patients were randomly divided into group A and group B,with 70 cases in each group.Patients in group A were treated with lidocaine intraductal injection,while those in group B were treated with tetracaine intraductal injection.Then the rate of irritating cough,HR,MAP,SBP,DBP,BIS and blood glucose,cortisol,β endorphin 5 minutes before extubation,immediately after extubation and 5 min after extubation were analyzed and compared between two groups.Results The rate of irritating cough in group B was significantly lower than that in group A.Fluctuation range of HR,MAP,SBP,DBP,BIS and blood glucose,cortisol,β endorphin in group B were significantly smaller than those in group A.Conclusion The effect of tetracaine in preventing irritating cough during extubation after sinus surgery under general anesthesia is better,and the stress response of patients is slighter.