双腔支气管导管热软化并涂抹达克罗宁对全身麻醉胸科手术患者插管期和拔管期心血管和咽喉部反应的影响

Effects of double-lumen endobronchial tube thermal softening and dacronin application on cardiovascular and throat response during intubation and extubation in patients undergoing thoracic surgery and general anesthesia

目的观察双腔支气管导管热软化并涂抹达克罗宁对全身麻醉胸科手术患者插管期和拔管期心血管和咽喉部反应的影响。方法选择60例全身麻醉下单肺通气行胸科手术患者,采用随机数字表法分为观察组与对照组,每组30例。两组患者均采用双腔支气管导管插管,观察组患者双腔支气管导管前端用40℃热水软化10 min,涂抹达克罗宁后进行插管,对照组双腔支气管导管前端涂抹石蜡油后进行插管。比较两组患者插管期和拔管期心血管反应、拔管期呛咳及躁动发生情况,以及术后咽喉痛、声音嘶哑等并发症发生率。结果观察组的心率、收缩压及舒张压随时间延长而变化的幅度均小于对照组(均P<0.05)。观察组拔管期躁动、呛咳发生率及拔管后咽喉痛、声音嘶哑发生率均低于对照组(均P<0.05)。结论热软化双腔支气管导管并涂抹达克罗宁胶浆可以减轻全身麻醉胸科手术患者插管期及拔管期的心血管反应,降低拔管期呛咳、躁动发生率及拔管后咽喉痛、声音嘶哑发生率。

Objective To observe the effects of double-lumen endobronchial tube thermal softening and dacronin application on cardiovascular and throat response during intubation and extubation in patients undergoing thoracic surgery and general anesthesia. Methods Sixty patients undergoing thoracic surgery with one-lung ventilation under general anesthesia were selected and divided into observation group and control group using random number table method,with 30 cases in each group.Patients in the two groups all used double-lumen endobronchial tube for intubation.In the observation group,the front end of double-lumen endobronchial tube was softened by hot water at 40℃ for 10 minutes,then dacronin was applied for intubation.In the control group,the front end of double-lumen endobronchial tube was daubed with paraffin oil for intubation.Cardiovascular response during intubation and extubation,incidence of cough and restlessness during extubation,and incidence rate of postoperative complications,such as throat pain and hoarseness,were compared between the two groups. Results The observation group reported a minor fluctuation of time-dependent changes in heart rate,SBP,or DBP than the control group(all P <0.05).The incidence rates of restlessness and cough during extubation and sore throat and hoarseness after extubation in the observation group were lower than those in the control group(all P <0.05). Conclusion Thermal softening of double-lumen endobronchial tube combined with application of dacronin mucilage can alleviate cardiovascular response during intubation and extubation in patients receiving thoracic surgery under general anesthesia,and reduce incidence rates of cough and restlessness during extubation and sore throat and hoarseness after extubation.