利多卡因与达克罗宁胶浆在气管插管中的应用效果比较

Comparison of application effect of lidocaine and dyclonine in endotracheal intubation

目的探讨并比较利多卡因与达克罗宁胶浆在全身麻醉气管插管中的应用效果。方法选取全身麻醉气管插管患者80例,ASAⅠ~Ⅱ级,随机分为两组,每组40例。A组患者在气管插管前1min应用2%利多卡因喷喉,B组将达克罗宁胶浆涂抹于气管导管前端,观察每组患者在入室时(T0)、插管即刻(T1)、插管后20min(T2)、拔管即刻(T3)、拔管后20min(T4)的心率(HR)、收缩压(SBP)、舒张压(DBP),记录两组患者拔管后2h咽喉部并发症发生情况。结果在T2时刻,A组SBP、DBP、HR与T0相比显著降低,在T2、T4时刻,B组SBP、HR与T0相比显著降低,差异均有显著性(P<0.05);在T3时刻,B组HR与T0相比明显降低,差异有显著性(P<0.05);在T2~T4时刻,A组咽喉疼痛、咳嗽和声音嘶哑发生率明显低于B组,差异有显著性(P<0.05)。结论利多卡因与达克罗宁胶浆均可以减轻患者在全身麻醉气管插管及拔管后的心血管反应;利多卡因可减少患者拔管后的不良反应,提高患者舒适度。

Objective To explore and compare the application effect of lidocaine and dyclonine in endotracheal intubation under general anesthesia.Methods Eighty patients(ASA physical status Ⅰ or Ⅱ) who underwent general anesthesia with endotracheal intubation,were randomly divided into two groups,40 cases in each group.People in group A received 2% lidocaine spraying the throat 1 minute before endotracheal intubation,People in group B used dyclonine to apply the front of the endotracheal tube.The heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP) was recorded when patients in each group enter the room(T0),intubation immediately(T1),20 minutes after intubation(T2),extubation immediately(T3),20 minutes after extubation(T4),laryngopharyngeal complications 2 hours after extubation were also recorded.Results At time T2,SBP,DBP,HR in group A were significantly reduced compared to T0,and at T2,T4,SBP,HR in group B were significantly reduced compared to T0,the differences were statistically significant(P<0.05);At time T3,the HR of group B was significantly lower than T0,the difference was statistically significant(P<0.05);At time T2~T4,the incidence of sore throat,cough and hoarseness in group A was significantly lower in group B,the difference was statistically significant(P<0.05).Conclusion Both lidocaine and dyclonine can reduce the cardiovascular response of patients who underwent general anesthesia after tracheal intubation and extubation;Lidocaine can reduce the adverse reactions of patients after tracheal extubation and improve patients’ comfort.