利多卡因凝胶在小儿全麻喉罩中的应用

The application of Lidocaine gel in laryngeal mask of pediatric anesthesia

目的观察利多卡因胶浆对小儿全麻喉罩插入不良反应的抑制作用。方法择期行下腹部手术的患儿80例,纳入标准:年龄3~9岁,ASA I^II级,排除标准:术前4周有上呼吸道感染病史、病态肥胖、张口度过小、存在异常口咽病变、心肺疾病、局麻药过敏者、手术时间超过2 h。按照随机数字表法将患儿随机均分为利多卡因凝胶组(A组)和石蜡油组(B组),每组各40例,分别将利多卡因凝胶和石蜡油涂抹于喉罩前端及背面尖端。于麻醉诱导后插入喉罩,分别记录插入喉罩前(T0)、插入喉罩时(T1)、插入喉罩后1min(T2)、3 min(T3)时SBP、DBP、HR及喉罩拔除时躁动情况,并观察术后48h内咽痛及咽部不适情况。结果二组患儿插入喉罩前、插入喉罩时、插入喉罩后1min、3 min时SBP、DBP、HR组间比较无统计学差异(P>0.05),A、B组患儿喉罩拔除时躁动发生率分别为12.5%、37.5%,A、B组患儿术后48内咽痛及咽部不适发生率分别为7.5%、25.0%,A组患儿较B组患儿术后躁动及术后咽痛、咽部不适发生率低(P<0.05)。结论利多卡因凝胶可降低小儿喉罩拔出时躁动及术后咽痛、咽部不适发生率。

Objective To observe the inhibitory effect of Lidocaine gel on adverse effect of insertion of laryngeal mask. Methods 80 cases undergoing selective lower abdominal operation were chosen. Inclusion criteria：age 3~9 years old;ASA I^II. Exclusion criteria：a history of upper respiratory infection for 4 weeks; morbid obesity; undersize mouth opening; abnormal oropharyngeal lesions;cardiopulmonary diseases;Allergy to local anesthetics or operation time of more than 2 hours. Patients were divided into lidocaine gel group （Group A） and paraffin oil group （Group B） randomly. There were 40 cases in each group, who were daubed lidocaine gel or paraffin oil on the front and back of laryngeal mask, respectively when the laryngeal mask was inserted after anesthesia induction, SBP、DBP、HR before insert （T0） and insert （T1）, insert for 1 minutes （T2）, for 3 minutes （T3）, and restlessness after pullout laryngeal mask were recorded. the postoperative sore throat and pharyngeal discomfort within 48 h were observed. Results There are no differences among SBP、DBP、HR before insert （T0）, insert （T1）, insert for 1 minutes （T2）, for 3 minutes（T3） between two groups （p〉0.05）, restlessness after pullout laryngeal mask between two groups are 12.5%and 37.5%respectively. The postoperative sore throat and pharyngeal discomfort within 48 h between two groups are 7.5%and 25%respectively, which is lower in Group A than that in Group B （p〈0.05）. Conclusion Lidocaine gel can reduce the restlessness, postoperative sore throat and pharyngeal discomfort after pullout laryngeal mask.