达克罗宁用于经口电子软镜引导下清醒气管插管效果观察

Effect of dyclonineon awake intubation under the guidance of electronic soft endoscopy

目的研究达克罗宁用于经口电子软镜引导下清醒气管插管应激反应的影响。方法将术前评估存在困难气道的患者60例,ASAⅠ~Ⅲ级,年龄45~72岁,随机分成两组。两组于操作前均给予阿托品0.5mg,持续泵注右美托咪定0.5μg/(kg?h),表面麻醉前均用2%利多卡因3ml行环甲膜穿刺。对照组(A组)用1%丁卡因表面麻醉,实验组(B组)用达克罗宁胶浆含漱,观察比较两组患者入室(T1)、表面麻醉5min后(T2)、电子软镜置入时(T3)、插管完成后(T4)、插管完成后5min(T5)的HR、SBP/DBP。记录置入电子软镜到插管完成所用时间(T0)以及患者术后随访咽痛和声音嘶哑的例数。结果两组均顺利完成气管插管,与A组比较,B组T2~T4HR、SBP/DBP波动较小(P<0.05),插管所用时间优于A组(P<0.05)。术后随访B组不良反应发生率明显低于A组(P<0.05)。结论达克罗宁胶浆表面麻醉用于经口电子软镜引导下清醒插管能有效降低患者的应激反应,缩短插管时间,维持血流动力学稳定,降低术后不良反应发生率。

Objective To study the effect of dyclonine on stress response of conscious tracheal intubation under the guidance of electronic soft microscope. Methods 60 patients (ASA I-III grade 45-72 years old) with difficult airway were randomly divided into two groups. The two groups were given atropine 0.5 mg before operation, and dexmetomidine 0.5 μg/(kg?g) by continuous pump. 2% lidocaine 3 ml was used for thyrocricocentesis before superficial anesthesia. The control group (group A) was treated with 1% tetracaine superficial anesthesia, and the experimental group (group B) was gargled with dyclonine glue. Observation and comparison of two groups of patients of HR and SBP/DBP at entering the operation room (T1), topical anesthesia 5 min later (T2), electronic soft mirror placement (T3), after the intubation is complete (T4), intubation 5 min later (T5). Record the time taken to complete the intubation (T0) and the number of cases of postoperative follow-up of pharynx pain and hoarseness. Results The tracheal intubation was completed successfully in both groups. Compared with group A, the fluctuation of T2-T4 HR, SBP/DBP in group B was smaller (P<0. 05), and the intubation time was better than that in group A (P<0. 05). The incidence of adverse reactions in group B was significantly lower than that in group A after follow-up. Conclusion Dyclonine glue can effectively reduce stress response, shorten intubation time, maintain hemodynamic stability and reduce the incidence of postoperative adverse reactions in patients with conscious intubation under the guidance of electronic soft endoscope, awake intubation.