利多卡因雾化吸入联合异丙酚在小儿纤维支气管镜检查中的作用

Effect of lidocaine aerosol inhalation combined with propofol on fiberoptic bronchoscopy in children

目的探讨利多卡因雾化吸入复合异丙酚在小儿纤维支气管镜(纤支镜)检查中的作用。方法本研究为病例对照研究。采用非随机抽样的方法选取2019年4月至2020年4月行纤支镜检查的小儿84例, 采用随机数字表法分为对照组(42例)和研究组(42例)。对照组予以异丙酚静脉麻醉, 研究组予以利多卡因超声雾化吸入复合异丙酚静脉麻醉。对比2组小儿纤支镜检查基础情况(包括时间、一次检查成功率和呛咳情况)、麻醉效果;对比2组纤支镜检查前(T1)、检查即刻(T2)、检查后1 min(T3)、检查后5 min(T4)和检查结束即刻(T5)的血流动力学指标(包括心率、平均动脉压、脉搏氧饱和度);对比2组不良反应发生率。结果研究组检查时间和呛咳评分均低于对照组[(15.14±2.03) min比(18.26±2.65)min, (2.13±0.33)分比(2.86±0.47)分, t值分别为6.06、8.24, P值均<0.001], 2组一次检查成功率比较差异无统计学意义[100.00%(42/42)比97.62%(41/42), χ^(2)=1.01, P=0.314]。研究组各时间点的心率和平均动脉压基本平稳, 而对照组的心率和平均动脉压逐渐上升, 随后下降, 2组在组间、时点间、以及组间和时点间交互作用差异均有统计学意义(P值均<0.05);2组各时间点的脉搏氧饱和度较平稳, 在组间、时点间以及组间和时点间交互作用差异均无统计学意义(P值均>0.05)。研究组不良反应发生率与对照组比较差异无统计学意义[11.90%(5/42)比7.14%(3/42), P=0.710]。结论使用利多卡因雾化吸入复合异丙酚用于小儿纤支镜检查可以缩短检查时间, 减轻呛咳程度, 维持血流动力学平稳, 且安全。

Objective To investigate the effect of lidocaine aerosol inhalation with propofol on fiberoptic bronchoscopy(FOB)in children.Methods This is a case-control study,adopting to non-random sampling method selected 84 children underwent FOB from April 2019 to April 2020.Those patients were divided into study group(n=39)and control group(n=39)according to the random digital table method.Lidocaine ultrasonic inhalation combined with intravenous anesthesia with propofol were performed in the study group,and intravenous anesthesia with propofol in control group.The key observation was the basic situation of FOB(including time,success rate of first examination,and choking cough),anesthetic effect,as well as hemodynamic indexes including heart rate(HR),mean arterial pressure(MAP),pulse oxygen saturation(SpO2)on different time points(before[T1],onset[T2],1 minute[T3],5 minutes[T4]and end[T5])between groups,and the incidences of adverse reactions were compared in group.Results The time and scores of choking cough in study group were lower than those in control group([15.14±2.03]min vs[18.26±2.65]min,[2.13±0.33]score vs[2.86±0.47]score,t=6.06,8.24,all P<0.05,respectively).There was no significant difference in success rate of first examination between groups[100.00%[42/42]vs 97.62%[41/42],χ^(2)=1.01,P=0.314,respectively].Each time point HR,MAP in study group were basically stable,while HR and MAP in control group increased gradually,and then decreased.There were significant differences between groups,time points,and the interaction between groups and time points(all P<0.05).Each time point pulse SpO2 in groups was relatively stable,and there was no significant difference between groups,time points,and the interaction between groups and time points(all P>0.05).There was no significant difference in the incidence of adverse reactions between study group and control group(11.90%[5/42]vs 7.14%[3/42],P=0.710,respectively).Conclusions Lidocaine aerosol inhalation combined with propofol for FOB in child is capable shorting examination time,reducing degree of cough,safely maintaining stable hemodynamics.