两种润滑剂在鼻咽通气管置管中的应用

Application of two kinds of lubricant in inserting nasopharyngeal endotracheal tube

目的比较利多卡因胶浆和石蜡油作为润滑剂在鼻咽通气管置管中的效果。方法将92例麻醉恢复室术后气管导管拔管后放置鼻咽通气管的老年肿瘤患者,随机分为利多卡因胶浆组(L组)和石蜡油组(P组)各46例。L组采用利多卡因胶浆和P组以石蜡油作为润滑剂在放置鼻咽通气管前均匀涂抹整条鼻咽通气管表面。比较两组患者置管成功率和所需时间、鼻腔黏膜损伤率,对比两组患者在鼻咽通气管置管前后不同时点的脉搏血氧饱和度(Sp O2)、血压(Bp)、心率(HR)变化及舒适度分级。结果两组患者在置管成功率、置管时间、黏膜损伤率及置管前后不同时点的脉搏血氧饱和度(Sp O2)、血压(Bp)、心率(HR)的差异无统计学意义;置管后L组的舒适度分级优于P组(P<0.05)。结论放置鼻咽通气管,使用利多卡因胶浆作为润滑剂可提高患者留置鼻咽通气管期间的舒适度。

Objective To investigate the effect of lidocaine hydrochloride mucilage and paraffin oil in inserting nasopharyngeal endotracheal tube as a lubricant .Methods 92 patients who need nasopharyngeal airway placements after extubation in postoperative anesthesia care unit （ PACU ） were included in this study and were randomly divided into 2 groups,46 cases in lidocaine hydrochloride mucilage group （group L） and 46 cases in paraffin oil group （ group P ） .Nasopharyngeal airway was lubricated with lidocaine hydrochloride mucilage before placement in group L and with paraffin oilin group P .We compared catheter placement success rate , injury rate of nasal mucosa , and the time required for a successful placement between two groups .And we also compared pulse oxygen saturation（SpO2）, heart rate（HR）, blood pressure and comfort level at different time points （before the incubation ,5 minute and 10 minute after the incubation ） between two groups .Results There were no significant differences in terms of intubation success rate , mucosal injury rate, placement comparison time ,the HR values, the value of SpO2 and the value of blood pressure at the study time points .The comfort level of group L was higher than of group P （P〈0.05）.Conclusions Compared to paraffin oil, lidocaine hydrochloride mucilage can increase the comfort level of patients incubated with nasopharyngeal airway .