利多卡因乳膏联合快诱导在卵巢囊肿剥除术麻醉中的应用

Application of Lidocaine Cream Combined Rapid Induction in General Anesthesia of Patients Underwent Oophorocystectomy

目的探讨利多卡因乳膏联合快诱导在卵巢囊肿剥除术患者手术麻醉中的应用效果。方法便利抽样法选择解放军总医院2013年9月至2014年5月收治的择期行卵巢囊肿剥除术的患者60例,按手术先后将60例患者分为A(健忘镇痛慢诱导组)、B(常规快诱导组)、C(利多卡因乳膏联合快诱导组)3组各20例,比较3组患者进入麻醉恢复室后、苏醒前(T0)、吸痰时(T1)、拔管时(T2)的血流动力学变化,耐管时间及拔管后24h咽部不适、咽痛的情况。结果 3组患者T0时刻血流动力学相关指标的差异无统计学意义(均P>0.05);T1和T2时刻A、C组的平均动脉压(mean arterial pressure,MAP)及心率(heart rate,HR)低于B组,A组低于C组,差异均有统计学意义(均P<0.05);3组患者的耐管时间的差异有统计学意义(P<0.05);拔管后24h,B组患者咽部不适及咽痛的发生率均高于A、C组(均P<0.05)。结论应用利多卡因乳膏联合快诱导进行麻醉对卵巢囊肿剥除术患者术后拔管有稳定血流动力学的作用,降低患者恢复期因血流动力改变引起的相应并发症的风险,减少患者恢复期咽痛的发生率。

Objective To investigate the application effect of Lidocaine cream combined rapid induction in general anesthesia of patients underwent oophorocystectomy.Methods By convenience sampling,60 female patients were selected and equally divided into group A （unmemorable analgesia slow induction group）, group B（routine rapid induction group）and group C（Lidocaine cream group）.The hemodynamic change when entering the postanesthesia care unit, before wake up （T0）, sputum suction （T1）,extubation time （T2）, and catheter tolerance time and throat discomfort at 24h of extubation,and the situation of throat discomfort were compared among three groups.Results There was no statistical significance of hemody- namic change relevant index at TO among three groups （all P〉0.05）.The mean arterial pressure and heart rate in group A and group C at T1 and T2 were lower than which in group B ,and group A was even lower than group C （all P〈0.05）. The statistical significance showed in catheter tolerance time among three groups （P〈0.05）.The incidences of throat discomfort and throat pain at 24 h of extubation in group B was higher than group A and C （all P〈0.05）.Conclusion The application of lidocaine cream combined rapid induction in general anesthesia can stabilize the hemodynamic change after extubation,and reduce the inci- dence of relevant complication caused by hemodynamic change during rehabilitation period,and also reduce the incidence of sore throat in recovery period.