利多卡因联合布地奈德雾化吸入对双腔支气管插管患者术后咽喉痛的影响

Effects of Budesonide Plus Lidocaine Inhalation on Relieving Postoperative Sore Throat After Tracheal Intubation with a Double-lumen Endobronchial Tube

【目的】探讨麻醉前和拔管后利多卡因联合布地奈德雾化吸入对支气管插管患者术后咽喉痛（postoperative sore throat ，POST ）的影响。【方法】拟行双腔支气管插管胸科手术患者160例，年龄18～64岁，随机分为四组，每组40例患者。对照组（C组）不进行雾化吸入，其余三组麻醉前30 m in和拔除支气管导管后各雾化吸入布地奈德1 mg （B组）；利多卡因100 mg （L组）；联合雾化吸入布地奈德1 mg ＋利多卡因100 mg （BL组）。记录拔管后1 h、3 h、6 h、24 h患者的咽痛、声嘶发生率及咽痛视觉模拟评分（Visual Analogue Score ，VAS）。【结果】拔管后各时间点B组、L组和BL组咽痛发生率及咽痛VAS评分明显低于C组（ P ＜0．05），且BL组明显低于B组和L组（ P ＜0．05），各组未见与雾化吸入药物相关的不良反应。【结论】利多卡因联合布地奈德早期雾化吸入能有效降低POST患者的发生率并减轻其严重程度。

[Objective] To evaluate the effects of an inhalation of lidocacine plus budesonide on the preven‐tion and treatment of postoperative sore throat （POST ） after tracheal intubation with a double_lumen endo‐bronchial tube before anesthesia and after extubation .[Methods]A total of 160 ASA I/II （aged 18～64 years） patients scheduled for elective thoracic surgery under general anesthesia were randomly divided into four groups （ n=40 each） .The patients received an inhalation of nothing （group C） ,100 mg lidocacine （group L） ,1 mg budesonide （group B） or 100 mg lidocacine plus 1 mg budesonide （group BL） at 30 min pre‐anesthe‐sia and after extubation with a double_lumen endobronchial tube .The incidence and visual analogue scale （VAS） score of POST at 1 ,3 ,6 and 24h postoperation after extubation were assessed .[Results] The inci‐dence and VAS score of POST were significantly lower in groups B ,L and BL than those of group C （ P 〈0 .05） and group BL lower than those of groups B and L （ P 〈0 .05） after extubation on a 4‐point scale .No adverse reaction associated with inhalation occurred in each group .[Conclusion] The combination of lidocacine and budesonide can reduce the incidence and VAS score of POST after tracheal intubation with a double‐lumen endobronchial tube .