达克罗宁胶浆对气管插管全麻扁桃体切除术患儿围术期咽喉部应激反应和疼痛不适的影响

The effect of dyclonine lubrication on the intubation and extubation stress response and pain tonsillectomy under general anesthesia with intubation

目的观察达克罗宁胶浆对行扁桃体切除术患儿气管插管和拔管期应激反应、术后咽喉痛、声音嘶哑和镇痛效果的影响。方法选择行扁桃体切除术患儿100例,将患儿按随机数字表分为两组各50例,观察组用达克罗宁胶浆均匀涂抹于气管导管前端1/3,对照组用生理盐水浸润相同部位,观察并记录两组患儿插管后和拔管期血流动力学的变化及呛咳、躁动、声门水肿和喉痉挛的发生情况及拔管后30 min患儿FLACC评分情况。结果观察组在气管插管后10 min、拔管时、拔管后5 min和30 min的平均动脉压(MAP)、心率(HR)都明显低于对照组(P<0.05);与对照组比较,观察组患儿苏醒期躁动、声音嘶哑和呛咳等呼吸道并发症发生率和拔管后30min FLACC评分明显降低(P<0.05)。结论气管导管前端1/3处涂抹达克罗宁胶浆可有效抑制扁桃体切除术患儿气管插管和拔管期的应激反应,减少术后声音嘶哑等呼吸道并发症的发生,具有起效迅速、持续时间较长的镇痛效果,可在小儿麻醉中选用。

Objective To study the effect of Dyclonine Lubrication on the intubation and extubation stress response and pain tonsillectomy under general anesthesia with intubation. Methods Children received tonsillectomy under general anesthesia with tracheal intubation were enrolled and randomly divided into 2 groups （n = 100） ： Dyclonine group and control group. Dyclonine hydrocholride mucllage（ 1% ） used in control group as replacement. The hemodynamics was applied as lubricant in dyclonine group, as saline was record during intubation and extubation, the occurrence of cough, restlessness, edema and spasm of the larynx, as well as the FLACC score 30 minutes after extubation were com- pared. Results HR and MAP in dyclonine group were significantly lower than control group 10 min after tracheal intubation, during intubation, and 5 min and 30 min after tracheal extubation. Moreover, compared with the control group, the occurrence of cough, restlessness, edema and spasm of the larynx were significantly lower in dyelonine group, and so as the FLACC score 30 rain after extubation. Conclusion Dyclonine Lubrication can effectively inhibit stress reaction, hoarseness and other respiratory complications during intubation and extubation, with rapid onset and long lasting analgesic effect.