利多卡因联合全身麻醉在支气管镜检查患者中的应用效果

Application effects of Lidocaine combined with general anesthesia in patients undergoing bronchoscopy

目的:观察利多卡因联合全身麻醉在支气管镜检查患者中的应用效果。方法:回顾性分析2022年3月至2023年3月该院收治的116例行支气管镜检查患者的临床资料,按麻醉方案不同将其分为观察组与对照组各58例。对照组采用全身麻醉,观察组采用利多卡因联合全身麻醉,比较两组麻醉效果、支气管镜检查时间、麻醉苏醒时间,不同时间点[麻醉前(T0)、麻醉后1 min(T_(1))、支气管镜进入声门时(T_(2))、取活检组织时(T_(3))、麻醉苏醒时(T_(4))]血流动力学指标[平均动脉压(MAP)、心率]水平,麻醉前、检查后应激反应指标[促肾上腺皮质激素(ACTH)、皮质醇(Cor)、丙二醛(MDA)]水平,以及不良事件发生率。结果:观察组麻醉优良率为94.83%(55/58),高于对照组82.76%(48/58),差异有统计学意义(P<0.05);两组支气管镜检查时间比较,差异无统计学意义(P>0.05);观察组麻醉苏醒时间短于对照组,差异有统计学意义(P<0.05);T_(1)时,两组MAP、心率水平均低于T0时,但观察组高于对照组;T_(2)~T_(3)时,观察组MAP、心率水平均低于对照组,T_(4)时,观察组MAP水平高于对照组,两组心率水平均高于T0时,但观察组低于对照组,差异有统计学意义(P<0.05);检查后,两组Cor、MDA、ACTH水平均高于麻醉前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率为10.34%(6/58),低于对照组的34.48%(20/58),差异有统计学意义(P<0.05)。结论:利多卡因联合全身麻醉应用于支气管镜检查患者可提高麻醉效果,缩短麻醉苏醒时间,稳定血流动力学指标水平,降低应激反应指标水平和不良事件发生率,其效果优于单纯全身麻醉。

Objective:To observe application effects of Lidocaine combined with general anesthesia in patients undergoing bronchoscopy.Methods:The clinical data of 116 patients who underwent bronchoscopy in this hospital from March 2022 to March 2023 were retrospectively analyzed.According to different anesthesia schemes,they were divided into observation group and control group,58 cases in each group.The control group was treated with general anesthesia,while the observation group was treated with Lidocaine combined with general anesthesia.The anesthetic effects,the bronchoscopy time,the anesthesia recovery time,the hemodynamic indexes[mean arterial pressure(MAP),heart rate]levels at different time points[before anesthesia(T0),1 min after anesthesia(T_(1)),bronchoscopy into the glottis(T_(2)),biopsy tissue(T_(3)),anesthesia awake(T_(4))],the stress reaction indexes[adrenocorticotropic hormone(ACTH),cortisol(Cor),malondialdehyde(MDA)]levels before anesthesia and after the examination,and the incidence of adverse events were compared between the two groups.Results:The excellent and good rate of anesthesia in the observation group was 94.83%(55/58),which was higher than that in the control group(82.76%,48/58),and the difference was statistically significant(P<0.05).There was no statistically significant difference in the bronchoscopy time between the two groups(P>0.05).The anesthesia recovery time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).At T_(1),the MAP and heart rate levels of the two groups were lower than those at T0,but those in the observation group were higher than those in the control group;at T_(2)-T_(3),thefluctuation of MAP and heart rate levels in the observation group was smaller than those in the control group;at T_(4),the MAP level of the observation group was higher than that of the control group;the heart rate levels of the two groups were higher than those at T0,but that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).After the examination,the levels of Cor,MDA and ACTH in the two groups were higher than those before anesthesia,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of adverse reactions in the observation group was 10.34%(6/58),which was lower than 34.48%(20/58)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Lidocaine combined with general anesthesia in the patients undergoing bronchoscopy can improve the excellent and good rate of anesthesia,shorten the anesthesia recovery time,stabilize the level of hemodynamic indexes,reduce the levels of stress reaction indexes and the incidence of adverse reactions.Moreover,it is superior to single general anesthesia.