罗哌卡因复合地塞米松气管内喷雾对患者耐管及术后咽喉痛的影响

Effect of ropivacaine combined with dexamethasone sprayed intratracheally in patients with resistant tubes and postoperative sore throat

目的 探讨罗哌卡因复合地塞米松气管内喷雾对患者耐管及术后咽喉痛的影响.方法 将80例ASA分级Ⅰ～Ⅱ级择期行妇科腹腔镜手术患者按随机数字表法分为四组,每组20例.插管前分别向气管内喷洒：0.75％罗哌卡因2ml＋地塞米松1ml（A组）,0.75％罗哌卡因2m1＋0.9％氯化钠1 ml（B组）,1％丁卡因3ml（C组）,0.9％氯化钠3ml（D组）.记录患者耐管情况及术后24h咽喉痛程度[采用疼痛视觉模拟量表（VAS）评分]、舒适度[采用Bruggrmann舒适度量表（BCS）评分]和咽喉痛发生率.结果 A、B、C组耐管评优率均明显高于D组[65.0％（13/20）,60.0％（12/20）,70.0％（14/20）比5.0％（1/20）],差异有统计学意义（P＜0.05）,A、B、C组比较差异无统计学意义（P＞0.05）.术后24h,A、B、C组咽喉痛发生率明显低于D组[20.0％（4/20）,25.0％（5/20）,25.0％（5/20）比90.0％（18/20）],差异有统计学意义（P＜0.05）,A、B、C组比较差异无统计学意义（P＞0.05）.A组咽喉痛VAS及BCS评分均明显优于B、C、D组[（0.52±1.14）分比（1.68±1.42）,（1.59±1.33）,（4.22±1.95）分,（2.80±1.54）分比（1.60±1.19）,（1.80±1.20）,（0.45±0.81）分],且B、C组明显优于D组,差异均有统计学意义（P＜0.05）；B、C组比较差异无统计学意义（P＞0.05）.结论 罗哌卡因复合地塞米松气管内喷雾增加了患者术后耐管的程度,显著减少了气管插管术后咽喉痛的发生率,增加了患者的舒适度.

Objective To investigate the effect of ropivacaine combined with dexanmethasone sprayed intratracheally in patients with resistant tubes and postoperative sore throat.Methods Eighty patients ASA Ⅰ-Ⅱ grade undergoing laparoscopic cholecystectomy were randomly divided into four groups by random digits tabel method,20 patients in each.2 ml of 0.75% ropivacaine combined with 1 ml dexamethasone （group A） ; 2 ml of 0.75% ropivacaine combined with 1 ml 0.9% sodium （group B） ; 3 ml of 1% tetracaine （group C）; 3 ml of 0.9% sodium （group D） were immediately intratracheal sprayed before intubation.The resistant tubes and degree of postoperative 24 h sore throat [by visual analog scale （VAS） scores],comfort [by Bruggrmann comfort scale （BCS） scores] and the incidence of sore throat were recorded.Results The resistant tubes appraised rate in group A,B and C was higher than that in group D [65.0% （13/20）,60.0% （12/20）,70.0% （14/20） vs.5.0% （1/20）] （P 〈 0.05）,but there was no significant difference among group A,B and C （P〉 0.05）.The incidence of sore throat at 24 h after surgery in group A,B and C was lower than that in group D [20.0%（4/20）,25.0% （5/20）,25.0% （5/20） vs.90.0% （18/20）] （P 〈 0.05）,but there was no significant difference among group A,B and C （P〉 0.05）.The VAS and BCS scores in group A were better than those in group B,C and D [（0.52 ± 1.14） scores vs.（1.68 ± 1.42）,（1.59 ± 1.33）,（4.22 ± 1.95） scores,（2.80 ± 1.54） scores vs.（1.60 ± 1.19）,（1.80 ± 1.20） and （0.45 ± 0.81） scores] （P 〈 0.05）,but there were no significant differences between group B and group C （P 〉 0.05）.Conclusion Ropivacaine combined with dexamethasone sprayedintratracheally can significantly increase the degree of postoperative resistant tubes,decrease the rate of sore throat after general anesthesia,and increase patient＇ s comfort.