利多卡因咽喉表面麻醉对腹腔镜胆囊切除术患者应激反应、血流动力学及恢复质量的影响

Effects of Lidocaine Throat Surface Anesthesia on Stress Response,Hemodynamics and Recovery Quality in Patients Undergoing Laparoscopic Cholecystectomy

目的:探讨利多卡因咽喉表面麻醉对腹腔镜胆囊切除术(LC)患者应激反应、血流动力学及恢复质量的影响。方法:采用随机数字表法将长沙市第一医院2019年4月-2021年6月期间收治的80例行LC患者分为对照组(40例,接受全身麻醉)和观察组(40例,对照组的基础上接受利多卡因咽喉表面麻醉)。对比两组血流动力学指标、应激反应指标、呛咳和躁动的发生情况、疼痛情况及生活质量。结果:观察组气管插管即刻(T1)~手术结束时(T4)收缩压(SBP)、舒张压(DBP)和心率(HR)低于对照组同期(P<0.05)。观察组术后即刻皮质醇(Cor)、促肾上腺皮质激素(ACTH)低于对照组(P<0.05)。观察组的呛咳发生率、躁动发生率以及总发生率明显低于对照组(P<0.05)。观察组术后6 h、术后12 h、术后24 h疼痛视觉模拟评分法(VAS)评分低于对照组同期(P<0.05)。观察组术后1个月活力、躯体疼痛、社会功能、生理功能、总体健康、精神健康、生理职能、情感职能评分高于对照组(P<0.05)。结论:利多卡因咽喉表面麻醉用于LC患者,可发挥气道保护作用,减轻患者的应激反应,维持患者血流的动力平衡,提高恢复质量。

Objective:To investigate the effects of lidocaine throat surface anesthesia on stress response,hemodynamics and recovery quality in patients undergoing laparoscopic cholecystectomy(LC).Methods:Using random number table method,80 patients undergoing LC who were admitted to Changsha First Hospital from April 2019 to June 2021 were divided into control group(40 cases,receiving general anesthesia)and observation group(40 cases,receiving lidocaine throat surface anesthesia on the basis of control group).Hemodynamic indexes,stress response indexes,occurrence of cough and agitation,pain condition and quality of life were compared in the two groups.Results:The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the observation group from the tracheal intubation immediately(T1)to the end of the operation(T4)were lower than those in the control group in the same period(P<0.05).The cortisol(Cor)and adrenocorticotropic hormone(ACTH)in the observation group at immediately after operation were lower than those in the control group(P<0.05).The incidence of cough,incidence of agitation and total incidence in the observation group were significantly lower than those in the control group(P<0.05).Visual analog scale(VAS)score in the observation group at 6 h after operation,12 h after operation and 24 h after operation were lower than those in the control group in the same period(P<0.05).The scores of vitality,physical pain,social function,physiological function,overall health,mental health,physiological function and emotional function in the observation group at 1 month after operation were higher than those in the control group(P<0.05).Conclusion:Lidocaine throat surface anesthesia for patients undergoing LC can play a protective role in the airway,reduce the stress response of patients,maintain the dynamic balance of patients'blood flow,and improve recovery quality.