摘要
目的观察复方利多卡因乳膏联合术前心理干预对留置导尿管引发的老年男性患者全麻苏醒期躁动的影响。方法全麻下实施腹腔镜胆囊切除手术的160例老年男性患者,ASAⅠ-Ⅱ级,随机分为4组(n=40):对照组(C组)、复方利多卡因乳膏处理组(L组)、术前心理干预组(X组)和复方利多卡因乳膏+术前心理干预组(LX组)。记录患者入室后脉搏血氧饱和度(SpO_2)、平均动脉压(MAP)及心率(HR)的基础值(T0)、术毕(T1)、拔管后3 min(T2)、10 min(T3)、20 min(T4)、30 min(T5)的血流动力学变化,观察记录拔管后患者因尿管刺激引发躁动的评分。结果 L组、X组及LX组患者麻醉苏醒期对尿管刺激反应程度明显低于C组,苏醒期血压、心率也较稳定,尤以LX组降低为甚。与同时间点的L组及X组比较,LX组T2、T3、T4时间点MAP明显降低,0-2级躁动情况存在显著性差异。结论复方利多卡因乳膏联合术前心理干预可以明显预防、减轻全麻术后因导尿管刺激而引发的躁动,血流动力学更加稳定,保障了老年男性患者全麻复苏期生命安全。
Objective To investigate the effect of compound lidocaine cream combined with preoperative psychological intervention on catheter-induced postoperative agitation in elderly male patients.Methods f60 ASA I or II elderly male patients undergoing laparoscopic gallbladder operation under general anesthesia were randomly allocated into four groups(n= 40):control group(C group),compound lidocaine cream treatment group(L group),preoperative psychological intervention group(X group) and compound lidocaine cream plus preoperative psychological intervention group(LX group).The levels of mean arterial pressure(MAP),heart rate(HR) and SpO_2 at baseline(T0),at the end of the surgery(T1),3 min after extubation(T2),10 min after extubation(T3),20 min after extubation(T4),30 min after extubation(T5) were recorded.The postoperative agitation scores caused by catheter stimulation after extubation were also recorded.Results Compared with C group,the degree of stimulation was significantly lower,the blood pressure and HR were more stable in L group,X group and LX group,especially in LX group.Compared with L group and X group at the same time point,MAP decreased more significantly in LX group at T2-T4 time point,and there were significant differences in 0-2 grades agitation.Conclusions Compound lidocaine cream combined with preoperative psychological intervention can prevent and reduce postoperative agitation caused by catheter stimulation after general anesthesia,and the hemodynamic is more stable,providing safety for the elderly male patients during the anesthesia recovery period.
出处
《实用老年医学》
CAS
2015年第8期649-652,共4页
Practical Geriatrics
基金
南京市医学科技发展项目(YKK 13068)
国家自然科学青年基金(181400914H0903)
关键词
复方利多卡因乳膏
心理干预
导尿管
术后躁动
compound lidocaine cream
psychological intervention
catheter
postoperative agitation