复方甘菊利多卡因凝胶对喉罩置入术相关并发症的预防效果

Efficacy of compound chamomile and lidocaine hydrochloride gel in prevention of complications related to laryngeal mask airway insertion

目的评价复方甘菊利多卡因凝胶对喉罩置入术相关并发症的预防效果。方法选择拟行全麻手术喉罩通气患者90例,年龄18~60岁,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为3组(n=30):石蜡油组(A组)、复方利多卡因乳膏组(B组)和复方甘菊利多卡因凝胶组(C组)。喉罩置入前按照分组分别将石蜡油、复方利多卡因乳膏或复方甘菊利多卡因凝胶均匀涂抹于喉罩前、肩、背部。于喉罩拔除后1、6、24和48 h时记录咽喉痛程度、口咽黏膜炎评分、声音嘶哑评分及各时段(0~1 h、>1~6 h、>6~24 h、>24~48 h)的发生情况:记录喉罩拔除时应激反应和喉罩拔除后48 h内药物相关不良反应发生情况。结果A组29例,B组28例,C组27例完成试验。与A组比较,C组喉罩拔除后各时点咽喉痛程度及各时段发生率降低,喉罩拔除后6、24和48 h时口咽黏膜炎评分及喉罩拔除后>1~48 h发生率降低,药物相关不良发应发生率升高(P<0.05);与B组比较,C组喉罩拔除后6 h时咽喉痛程度及喉罩拔除后>1~48 h咽喉痛发生率降低,喉罩拔除后6、24和48 h时口咽黏膜炎评分及喉罩拔除后>1~48 h口咽黏膜炎发生率降低,药物相关不良反应发生率降低(P<0.05)。3组喉罩拔除后声音嘶哑评分及其发生率、喉罩拔除时应激反应发生率比较差异无统计学意义(P>0.05)。结论复方甘菊利多卡因凝胶对喉罩置入术相关并发症有一定预防效果。

Objective To evaluate the efficacy of compound chamomile and lidocaine hydrochloride gel in prevention of complications related to laryngeal mask airway(LMA)insertion.Methods Ninety American Society of Anesthesiologists physical statusⅠorⅡpatients,aged 18-60 yr,undergoing elective surgery with ventilation using LMA under general anesthesia,were divided into 3 groups(n=30 each)using a random number table method:paraffin oil group(group A),compound lidocaine cream group(group B),and compound chamomile and lidocaine hydrochloride gel group(group C).The paraffin oil,compound lidocaine cream,and compound chamomile and lidocaine hydrochloride gel were evenly applied on the front,shoulder and back of the LMA before inserting the LMA in A,B and C groups,respectively.The severity of sore throat,oropharyngeal mucositis score,hoarseness score and occurrence in each time period(0-1 h,>1-6 h,>6-24 h,>24-48 h)were recorded at 1,6,24 and 48 h after removal of the laryngeal mask.The stress responses during removal of the LMA and occurrence of drug-related adverse reactions within 48 h after removal of LMA were recorded.Results Twenty-nine cases in group A,28 cases in group B and 27 cases in group C completed the trial.Compared with group A,the severity of sore throat at each time point after removal of the LMA and incidence of sore throat in each time period were significantly decreased,the oropharyngeal mucositis score at 6,24 and 48 h after removal of the LMA and the incidence of oropharyngeal mucositis in the time period>1-48 h were decreased,and the incidence of drug-related adverse reactions was increased in group C(P<0.05).Compared with group B,the severity of sore throat at 6 h after removal of the LMA and incidence of sore throat>1-48 h after removal of the LMA were significantly decreased,the oropharyngeal mucositis score at 6,24 and 48 h after removal of the LMA and incidence of oropharyngeal mucositis in the time period>1-48 h after LMA removal were reduced,and the incidence of drug-related adverse reactions was decreased in group C(P<0.05).There was no significant difference in the hoarseness score and incidence of hoarseness after removal of the LMA and incidence of stress responses during removal of the LMA among the three groups(P>0.05).Conclusions Compound chamomile and lidocaine hydrochloride gel has a certain efficacy in preventing complications related to LMA placement.