多功能新型气管导管套囊内给予利多卡因对拔管反应的影响

Effect of lidocaine on the extubation reaction in a multi-functional new tracheal tube cuff

目的探讨新型气管导管套囊内给予利多卡因对腹腔镜胆囊切除术患者气管拔管反应的影响。方法选取2018年4月~2019年4月期间在本院择期行腹腔镜胆囊切除术,ASA分级为Ⅰ~Ⅱ级的患者,按随机区组的原则分为空白组、套囊生理盐水组、套囊利多卡因组、喉麻管组,每组40例。比较拔管即刻、拔管后5 min血流动力学的变化情况,以及苏醒期呛咳反应评分。结果(1)在拔管即刻和拔管后5 min,套囊利多卡因组、喉麻管组与套囊生理盐水组相比,患者的收缩压、舒张压、平均动脉压、心率均显著下降,差异有统计学意义(P<0.05)。与喉麻管组相比,套囊利多卡因组上述各项指标也显著下降,差异有统计学意义(P<0.05)。(2)在拔管即刻,与空白组相比,套囊生理盐水组、套囊利多卡因组、喉麻管组患者的呛咳评分显著下降,差异有统计学意义(P<0.05)。套囊利多卡因组和喉麻管组相比无统计学差异(P>0.05)。结论新型气管导管套囊内给予利多卡因可以有效抑制拔管时患者的心血管反应、降低呛咳反应、提高患者的舒适度。

Objective To investigate the effect of lidocaine in the multi-functional new tracheal tube cuff on extubation reaction.Methods Patients with ASA gradeⅠ-Ⅱwho underwent elective laparoscopic cholecystectomy from April 2018 to April 2019 were enrolled.They were divided into the blank group and cuff saline group,cuff lidocaine group,and throat tube anesthesia group according to the principle of randomized block,with 40 cases in each group.The changes in hemodynamics immediately after extubation and 5 min after extubation,and the score of cough response during recovery were compared.Results(1)The systolic blood pressure,diastolic blood pressure,mean arterial pressure and heart rate of the cuff lidocaine group and the laryngeal tube anesthesia group were significantly lower than those of the cuff saline group immediately after extubation and 5 minutes after extubation,and the difference was statistically significant(P<0.05).Compared with those of the throat tube anesthesia group,the above-mentioned indicators were also significantly decreased in the cuff lidocaine group,and the difference was statistically significant(P<0.05).(2)Immediately after extubation,the cough score of the cuff saline group,the cuff lidocaine group and the laryngeal tube anesthesia group was significantly decreased compared with that of the blank group,and the difference was statistically significant(P<0.05).There was no statistical difference between the cuff lidocaine group and the throat tube anesthesia group(P>0.05).Conclusion Lidocaine in the new tracheal tube cuff can effectively inhibit the cardiovascular response,reduce cough response and improve patients'comfort during extubation.