达克罗宁胶浆用于小儿气管插管全身麻醉的效果

Evaluation of dyclonine mucilagines used in endotracheal intubation for general anesthesia in pediatric patients

目的将达克罗宁胶浆涂抹于气管导管套囊及其前端，评价这种处理对小儿全身麻醉血流动力学的影响和减轻拔除气管导管期间不良反应的效果。方法择期行气管插管全身麻醉手术的患儿80例，年龄3～8岁，美国麻醉医师协会（ASA）分级I或Ⅱ级，随机分人达克罗宁胶浆组和对照组，每组40例。分别将达克罗宁胶浆或石蜡油涂抹于气管导管套囊及其前端，记录两组患儿围术期平均动脉压（MAP）和心率（HR），以及拔除气管导管期间躁动、呛咳、屏气、声嘶、咽喉部不适等不良反应的发生情况。结果达克罗宁胶浆组患儿在拔除气管导管即刻、拔除气管导管后5rain的MAP均显著低于对照组同时间点（P值均〈0．05），HR显著慢于对照组同时间点（P值均〈0．05）。达克罗宁胶浆组躁动程度评分为0～1分的患儿比例显著高于对照组（P〈0．05），而评分为2和3分的患儿比例均显著低于对照组（P值均〈0．05）；达克罗宁胶浆组术后呛咳、屏气和咽部不适发生率均显著低于对照组（P值均〈0．05）。结论达克罗宁胶浆应用于小儿气管插管全身麻醉，有利于维持患儿围术期血流动力学的平稳，减少因气管导管刺激引起的术后并发症，提高麻醉平稳舒适度。

Objective To evaluate the effect of dyclonine mucilagines on hemodynamics and adverse reactions of endotracheal intubation and extubation for general anesthesia in pediatric patients. Methods Eighty pediatric patients, aged 3--8 years old, American Society of Anesthesiologists （ASA） grade Ⅰ or Ⅱ, undergoing elective surgery under general anesthesia, were randomly divided into dyclonine group and control group （n = 40）. The dyclonine mucilagines and paraffin oil were daubed on the cuff and the end of tracheal tube in the two groups, respectively. Perioperative mean arterial pressure （MAP） and heart rate （HR）, agitation, choking cough or breathlessness during extubation and hoarseness, and throat discomfort after extubation were recorded. Results At the time points of tracheal extubation and 5 minutes after tracheal extubation, MAP and HR in the dyclonine group were significantly lower than those in the control group （all P〈0.05）. The agitation score was 0 -- 1 in more patients of the dyclonine group than the control group, while the score was 2 - 3 in less patients of the dyclonine group than the control group （all P〈0.05）. The incidences of choking cough, breathlessness and throat discomfort in the dyclonine group were significantly lower than those in the control group （all P 〈0. 05）. Conclusion Application of dyclonine mucilagines in pediatric endotracheal anesthesia is associated with more stable hemodynamics, fewer postoperative complications and better anesthesia comfort.