预防气管内导管拔管反应研究进展

Research advances on methods for preventing extubation reaction

由于围拔管期麻醉药物逐渐代谢完全,患者对气管导管的耐受能力降低,患有心脑血管疾病的患者容易出现呛咳和血流动力学的急剧波动,从而导致一些并发症。麻醉医师有必要采取抑制拔管反应的措施来预防全身麻醉苏醒期并发症。文章介绍了多种抑制拔管反应的方法:静脉使用利多卡因、静脉使用右美托咪定、靶控输注瑞芬太尼、利多卡因局部麻醉、罗哌卡因局部麻醉、复方利多卡因乳膏表面麻醉以及深麻醉下拔管等。此外,需要明确这些方法的优缺点,为进一步探寻更佳的抑制拔管反应方法提供基础,进而减少围手术期并发症的发生。

Because anesthetics are gradually metabolized completely during the peri‐extubation period,patients'tolerance to the endotracheal tube was decreased.Susceptible patients who have cardiovascular and cerebrovascular diseases are prone to cough and dramatic fluctuations in hemodynamics,which leads to complications.It is necessary for anesthesiologists to take measures to in‐hibit extubation reaction so that prevent complications during emergence of general anesthesia.This review described several methods for inhibiting extubation reaction:intravenous lidocaine,dexmedetomidine,targeted controlled infusion remifentanil,lidocaine local an‐esthesia,ropivacaine local anesthesia,compound lidocaine cream topical anesthesia and extubation under deeply anesthesia.Moreover,the advantages and disadvantages of these methods need to be clarified.This may provide a basis for further searching for better meth‐ods to suppress extubation reaction so as to reduce perioperative complications.