利多卡因不同给药方式对颌面外科经鼻气管插管患者全身麻醉苏醒期不良反应的临床研究

Clinical study of adverse effects of different administration methods of lidocaine on recovery period of general anesthesia in maxillofacial surgery patients with nasal tracheal intubation

目的:探讨利多卡因经气管内和静脉给药对颌面外科经鼻气管插管手术患者全身麻醉苏醒期的影响。方法:选取2023年2月~11月南通市口腔医院颌面外科经鼻气管插管手术患者90例,按照苏醒期不同给药方式分为三组。术毕时A组(n=30):利多卡因1 mg/kg经静脉推注;B组(n=30):利多卡因1 mg/kg经气管导管注入;C组(n=30):未干预。对比分析三组患者镇静镇痛效果、血流动力学变化及呛咳情况。结果:三组苏醒时间比较,差异无统计学意义(P>0.05);T2(拔管时)三组患者心率、血压均升高,并缓慢降低,A组、B组升高幅度低于C组,B组最低,差异有统计学意义(P<0.05);拔管后10 min,A组、B组镇静镇痛效果优于C组,B组疼痛评分最低,差异有统计学意义(P<0.05);吸痰和拔管时A组、B组呛咳率低于C组,B组发生率最低,差异有统计学意义(P<0.05)。结论:颌面外科经鼻插气管插管患者术后经气管内给予利多卡因,具有较好的镇静镇痛效,利于维持血流动力学的稳定,并减少呛咳的发生。

Objective To analyze the effects of lidocaine administration through air tube and vein on the recovery period of general anesthesia in patients undergoing nasotracheal intubation in maxillofacial surgery.Method A total of 90 patients with nasotracheal intubation in the Maxillofacial surgery Department of Nantong Stomatology Hospital from February to November 2023 were selected and divided into three groups according to different administration methods during the recovery period.After surgery,group A(n=30):lidocaine 1mg/kg was injected intravenously;Group B(n=30):lidocaine 1mg/kg was injected through a tracheal catheter;Group C(n=30):No intervention.The effects of sedation and analgesia,hemodynamic changes and coughing were compared among the three groups.Results The recovery time of the three groups was compared(P>0.05).The heart rate and blood pressure of patients in T2(extubation)increased and slowly decreased,and the increase rate of group A and B was lower than that of group C,and group B was the lowest(P<0.05).10 min after extubation,the sedative and analgesic effect of groups A and B was better than that of group C,and the pain score of group B was the lowest(P<0.05).During sputum aspiration and extubation,the coughing rate of groups A and B was lower than that of group C,and the incidence of group B was the lowest(P<0.05).Conclusion In maxillofacial surgery patients with tracheal intubation through the nasal tube,lidocaine has a good sedative and analgesic effect,which is conducive to maintaining the stability of hemodynamics and reducing the occurrence of cough.