复方利多卡因乳膏在全身麻醉胃减容术苏醒期中的作用研究

Effect study of Compound Lidocaine Cream in the recovery period of general anesthesia for gastric reduction surgery

目的探讨复方利多卡因乳膏在全身麻醉胃减容术苏醒中的作用。方法选取2015年10月~2016年3月在我院择期行全身麻醉下腹腔镜胃减容术的60例患者作为研究对象,BMI为35~58.5 kg/m^2。将入选患者随机分为L组(复方利多卡因乳膏组)和C组(对照组),各30例。L组气管导管前1/3涂抹1.0~1.5 g复方利多卡因乳膏,C组气管导管表面不涂任何药物。比较两组麻醉前(T_0)、拔管前1 min(T_1)、拔管即刻(T_2)、拔管后1 min(T_3)、拔管后3 min(T_4)、拔管后5 min(T_5)的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)水平,记录两组苏醒拔管过程中的屏气、呛咳和烦躁发生情况。结果 C组T_1~T_5各时间点的MAP和HR值高于T_0时间点值,差异有统计学意义(P<0.05);T_3~T_5时间点的SpO_2值低于T_0时间点值,差异有统计学意义(P<0.05)。L组T_1~T_5各时间点的MAP、HR和SpO_2值与T_0时间点值比较,差异无统计学意义(P>0.05)。L组T_1~T_5各时间点的MAP和HR值显著低于C组对应时间点值,差异有统计学意义(P<0.05);T_3~T_5时间点的SpO_2值高于C组对应时间点值,差异有统计学意义(P<0.05)。L组的呛咳、屏气、躁动等不良反应发生率低于C组,差异有统计学意义(P<0.05)。结论复方利多卡因乳膏涂抹于气管导管外壁可有效抑制全身麻醉胃减容术苏醒期气管导管的刺激,使患者平稳度过苏醒拔管期。

Objective To explore the effect of Compound Lidocaine Cream in the recovery period of general anesthesia for gastric reduction surgery.Methods 60 patients underwent selective gastric reduction surgery under general anesthesia from October 2015 to March 2016 in our hospital were selected as the research subjects,the body mass index was 35-58.5 kg/m^2.All patients were randomly divided into group L （Compound Lidocaine Cream group） and group C （the control group）,30 cases in each group.The first 1/3 tracheal catheter in group L was applied with 1.0-1.5 g Compound Lidocaine Cream,while,no medication was applied to the tracheal catheter in group C.The level of mean arterial pres-sure （MAP）,heart rate （HR） and oxygen saturation （SpO2） before anesthesia （T0）,l min before extubation （T1）,extubation @2）,1 min after extubation （T3）,3 min after extubation （T4）,5 min after extubation @5） in the two groups were compared, the incidence rate of cough reflex,breath holding and restlessness during extubation in the two groups were recorded. Results The level of MAP and HR in group C at %-T5 was higher than that at T0,with significant difference （P〈0.05）. The level of SpO2 in group C at T3-T5 was lower than that at T0,with significant difference （P〈0.05）.There was no signif- icant difference in the level of MAP,HR and SpO2 in group L between T1-T5 and To （P〉0.05）.The level of MAP and HR in group L at %-T5 was lower than that in group C at T1-T5,with significant difference （P〈0.05）.The level of SpO2 in group L at T3-T5 was higher than that in group C at T3-T5,with significant difference （P〈0.05）.The incidence rate of-cough reflex,breath holding and restlessness during extubation in group L was lower than that in group C,with significant difference （P〈0.05）.Conclusion Application of Compound Lidocaine Cream applied to the outer wall of the tra-cheal catheter can effectively inhibit the stimulation of tracheal catheter in the recovery period of general anesthesia for gastric reduction surgery,make the patient get through the recovery and extubation period smoothly.