碳酸利多卡因表面麻醉在纤维支气管镜检查中的应用

Clinical application of surface anesthesia using lidocaine carbonate in fiberoptic bronchoscopy

目的探讨碳酸利多卡因(LC)在纤维支气管镜(FB)检查中的应用价值。方法选取FB检查患者126例,分为观察组66例和对照组60例,在FB检查过程中分别使用LC和盐酸利多卡因(LH)行表面麻醉,使用多参数监护仪监测患者指脉氧(Sp O2)、心率(HR)及呼吸频率(RR)的变化情况,并计算指脉氧变异率(Sp O2-VR)、心率变异率(HR-VR)及呼吸频率变异率(RR-VR),记录FB检查时间及评价麻醉效果,比较两组间各参数的差异性。结果观察组及对照组的Sp O2-VR分别为(4.17±4.54)、(5.62±5.37)(P=0.103>0.05),差异无统计学意义;HR-VR分别为(2.54±1.36)、(2.91±1.5)(P=0.147>0.05),差异无统计学意义;RR-VR分别为(4.09±1.79)、(4.98±1.97)(P=0.009<0.05),差异有统计学意义;FB检查时间分别为(8.59±3.73)min、(8.55±3.27)min(P=0.948>0.05),差异无统计学意义;观察组的麻醉效果满意度优于对照组,差异有统计学意义(P<0.05)。结论在FB检查过程中,LC的表面麻醉效果优于LH,使用LC的患者呼吸较平稳,建议在FB检查中使用LC进行表面麻醉。

Objective To explore the effect of surface anesthesia using lidocaine carbonate （LC） in fiberoptic bronchoscopy （FB）. Methods 126 cases undergoing FB in our hospital were randomly divided into the experimental group using lidocalne carbonate （LC） and the control group using Lidoeaine hydrochloride （LH） for surface anesthesia. The changes of finger pulse oxygen （ SpO2 ）, heart rate （HR） and respiratory rate （RR） during the FB process were recorded using multi parameter monitor instrument. And the finger pulse oxygen variation rate （SpO2-VR）, heart rate variability （HR-VR） and respiratory frequency variation rate （RR-VR） were calculated. The examination time and anaesthetic effect were recorded. Results The SpO2-VR of the experimental group and the control group of were 4.17 ± 4.54, 5.62 ± 5.37 respectively（P =0. 103 〉0.05）. The HR-VR were 2. 54 ± 1.36, 2.91 ± 1.5 respectively （P = 0. 147 〉 0.05 ）. The RR-VR were 4.09±1.79, 4.98 ± 1.97 respectively （ P = 0. 009 〈 0.05 ）, with the significant difference. The examination time was 8.59 ±3.73 min, 8.55 ± 3.27min, respectively （ P = 0. 948 〉 0.05 ）. The anesthetic effect of the experimental group was significantly better than that of the control group （P〈0.05）. Conclusions Lidocaine carbonate （LC） used for surface anesthesia in fiberoptic bronchoscopy, has better anesthetic effect than Lidocaine hydrechloride, without affecting breath, worth clinical application.