复方利多卡因乳膏用于脑动脉瘤夹闭术麻醉预防心血管应激反应研究

Lidocaine cream Anesthesia for cerebral aneurysms stress response prevention of cardiovascular research

目的观察复方利多卡因乳膏用于脑动脉瘤夹闭术全麻插管患者,旨在评价对抑制气管导管刺激引起的心血管应激反应的效果。方法选择40例急、慢诊脑动脉瘤夹闭术患者,ASA为Ⅱ-Ⅳ级,拟施全麻气管插管行动脉瘤夹闭术,并随机分为两组,每组20例。对照组（I组）,不使用复方利多卡因乳膏涂抹气管导管,实验组（II组）,将复方利多卡因乳膏均匀涂抹气管导管套囊及前端,麻醉诱导后行气管内插管。分别记录患者在麻醉前、插管前、插管时、变动体位、抬头消毒和拔管时平均动脉压（MAP）和心率（HR）。结果插管时与插管前,I组患者明显出现一过性MAP升高和HR增快。而II组插管刺激反应弱于I组。组间与同时刻比较,差异有统计学意义（P〈0.05）。在变动体位和抬头消毒时与插管前I组仍出现MAP升高和HR增快现象。而II组却无明显变化,组间与同时刻比较,差异有统计学意义（P〈0.05）。在拔管时与插管前,I组患者明显出现MAP升高和HR增快现象,而II组却弱于I组,组间与同时刻比较,差异有统计学意义（P〈0.05）。结论将复方利多卡因乳膏均匀涂抹气管导管用于脑动脉瘤夹闭术全麻插管患者,可以有效抑制气管导管刺激引起的心血管应激反应。

Objective To observe the compound lidocaine cream for patients with cerebral aneurysms anesthesia intubation , aimed at evaluation of the inhibition of the cardiovascular effects of stimulation of the endotracheal tube stress response .Methods 40 cases of acute and chronic cerebral aneurysm surgery clinic , ASA Ⅱ-Ⅳ grade is intended to apply anesthesia endotracheal intubation aneurysm surgery were randomly divided into two groups , 20 cases in each group , the control group （ group Ⅰ , do not use lidocaine cream applied endotracheal tube ） and the experimental group （ Ⅱ group , the compound lidocaine cream evenly coated endotracheal tube cuff and front ） , underwent induction of anesthesia endotracheal intubation .Patients were recorded before anesthesia , before intubation , during intubation , changes in body position , disinfection and extubation rise in mean arterial pressure （ MAP） and heart rate （ HR） test data .Results When the results of the two groups were compared with before intubation intubation MAP and HR test data , Ⅰ obviously patients had transient increase in MAP and HR faster ;while Ⅱ stimulation group was weaker than Ⅰ intubation group , between groups comparison with the same time the existence of significant differ -ences （P〈0.05）.Compared with before intubation MAP and HR data when detecting changes in body position and looked disinfection , Ⅰ group still appears MAP and HR increased faster phenomenon ;whereas group Ⅱ but no significant change between the two groups with the same time there are obvious differences in contrast （P〈0.05）.Compared with before intubation MAP and HR test data when extubation , Ⅰ group were significantly increased MAP and HR appear faster phenomenon , but weaker than Ⅰ group Ⅱ group , there are significant differences be-tween the groups compared with the same time of （P〈0.05）.Conclusion The compound lidocaine cream evenly coated endotracheal intuba-tion anesthesia for brain aneurysm patients , the endotracheal tube can effectively inhibit the stimulation of the cardiovascular stress response .