利多卡因喉部表面浸润麻醉在支撑喉镜下声带息肉摘除术中的临床观察

Clinical observation of laryngeal surface infiltration anesthesia of lidocaine in suspesion laryngoscopy vocal cord polypectomy

目的 探讨利多卡因喉部表面浸润麻醉在支撑喉镜下声带息肉摘除术中的心血管效应及术后苏醒躁动情况。方法 2013年6～9月选择20-50岁、美国麻醉医师协会分级Ⅰ-Ⅱ级，在全身麻醉下行支撑喉镜下声带息肉摘除术的患者40例，随机分为对照组和观察组各20例。对照组患者在诱导后3min进行气管插管；观察组患者在诱导后2min用喉麻管向会厌、气管内喷注5mL2%利多卡因，再经过2min进行气管插管。观察和比较两组患者围术期血流动力学指标变化情况及麻醉苏醒期的躁动情况。结果 观察组患者血流动力学指标变化情况明显优于对照组，且躁动评分明显低于对照组，差异均有统计学意义（P〈0.05）。结论 利多卡因喉部表面浸润能有效地减轻支撑喉镜下全身麻醉患者的心血管反应，减少术后躁动，可以良好地应用到支撑喉镜下声带息肉摘除术中。

Objective To explore the cardiovascular effect and the emergence agitation during the recovery period with laryngeal surface infiltration anesthesia of lidocaine in suspension laryngoscopy vocal cord polypectomy. Methods A total of 40 patients,aged 20-50-year-old,with American Society of Anesthesiologists（ASA）Ⅰ-Ⅱin suspension laryngoscopy vocal cord polypectomy under general anesthesia from June to September of 2013 ,were selected and randomly divided into the control group and the observation group,20 cases in each group. The patients of the control group were treated with endotracheal intubation after 3 minutes when the induction is finished while those of the observation group with 5 mL 2%lidocaine to the epiglottis and in the trachea by laryngotracheal topical anesthesia kit and then with endotracheal intubation after 2 minutes. It was compared with hemodynamic parameters change during the perioperational period and the emergence agitation during the recovery period of the two groups. Results The hemodynamic parameters change of the observation group was significantly better than that of the control group while the emergence agitation rating was lower than the that of the control group ,which had statistical difference （P〈0.05）. Conclusion Laryngeal surface infiltration of lidocaine can effectively reduce the cardiovascular reaction and the emergence agitation during the recovery period ,and it can be favourably applied to suspension laryngoscopy vocal cord polypectomy.