经呼吸回路雾化吸入利多卡因在ICU床旁纤维支气管镜中的应用

The Application of Lidocaine Nebulization Inhalation through Breathing Circuit in ICU Bedside Fiberoptic Bronchoscopy

目的探讨经呼吸回路雾化吸入利多卡因预防床旁纤维支气管镜操作过程中不良反应的临床效果。方法选择2011年3月至2012年12月在遵义市第一人民医院重症监护室住院的患者64例,随机分为滴入组和雾化组,每组32例,观察两组患者纤维支气管镜操作过程中利多卡因用量、不良反应发生率、中止操作次数以及心率、血压、血氧饱和度变化情况。结果雾化组利多卡因总用量显著低于滴入组(P=0.003),雾化组术中心率显著低于滴入组(P=0.026),滴入组术中平均动脉压较术前显著增高(P=0.013),雾化组与术前比较无明显变化。结论在已建立人工气道行机械通气的患者中经呼吸回路雾化吸入利多卡因能获得较好的气道黏膜麻醉效果,显著降低纤维支气管镜操作过程中心血管不良反应。

Objective To research the prevention effect of lidocaine nebulization inhalation through breathing circuit on adverse effect in fiberoptic bronchoscopy test and therapy. Methods During Mar. 2011 and Dec. 2012 in Zunyi First People＇s Hospital ,64 ICU patients who underwent fibereptic brenchoscopy were randomly allocated to group A and B （32 cases in each group）, lidocaine was injected from artificial airway in group A and inhaled with aerosolizer though breathing circuit in group B. The dosage of lidocaine, adverse effects ,operation abortion times,heart rate（HR） ,blood pressure and blood oxygen saturation changes of the two groups were observed. Results The total dosages of lidocalne in group B was significantly fewer than that of group A（P =0.003） ,HR of group B in operation was significantly lower than group A（P =0. 026）. Compare with baseline, MAP was not signficantly changed in group B while increased significantly in group A（P =0. 013 ）. Condusion After lidocaine nebulization inhalation through breathing circuit, better anaesthesia effective- ness and fewer cardiovascular adverse effects can be obtained in fiberoptic bronchoscopy test and therapy.