摘要
目的:评价不同浓度利多卡因在保留自主呼吸气管插管中的应用价值。方法:选取2015年2月-2016年2月笔者所在医院收治的择期手术进行气管插管全麻患者146例入组,随机分为低浓度组与高浓度组,各73例,保留自主呼吸慢诱导,可视喉镜下经口气管插管。低浓度组与高浓度组分别用浓度为1.5%和2%的利多卡因喷喉,然后两组患者均给予硫酸阿托品注射液0.5 mg+咪达唑仑注射液2.0 mg+枸橼酸舒芬太尼注射液5.0μg静脉基础麻醉,低浓度组1.5%利多卡因3 ml环甲膜穿环刺局麻;高浓度组2%利多卡因3 ml环甲膜穿刺局麻。3 min后放置可视频喉镜进行气管插管。比较基础值(T0)、插管即刻(T1)两组对象的中心静脉压(BP)、心率(HR)及插管后全身麻醉前其峰值,以及插管质量指标。结果:低浓度组BP、HR插管后全麻前峰值较基础值变化幅度高于高浓度组,差异有统计学意义(P<0.05);高浓度组插管时间为(34.3±10.1)s,短于低浓度组的(56.5±15.3)s,比较差异有统计学意义(P<0.05);高浓度组一次插管成功率为100%,高于低浓度组的87.67%,呛咳、插管并发症发生率分别为0、4.11%,低于低浓度组的8.22%、15.07%,比较差异均有统计学意义(P<0.05)。结论:2%的利多卡因麻醉效果更好,有助于减轻插管带来的负面影响,稳定循环。
Objective：To evaluate the application value of different concentrations of Lidocaine in spontaneous respiration tracheal intubation.Method：From February 2015 to February 2016,146 patients with tracheal intubation under general anesthesia in our hospital were enrolled and randomly divided into the low-concentration group and the high-concentration group with 73 cases in each group,spontaneous breathing and slow induction anesthesia were performed under visual laryngoscope via oral trachea cannula.Lidocaine throat spray,drug level of the low-concentration group was 1.5%,of the highconcentration group was 2%,combined with Atropine 0.5 mg and Midazolam 2.0 mg and Sufentanil 5 g,the low-concentration group：1.5% Lidocaine 3 ml thyrocricoid puncture piercing local anesthesia;the high-concentration：2% Lidocaine 3 ml thyrocricoid puncture local anesthesia.Tracheal intubation with video laryngoscope after 3 min.The blood pressure and heart rate were compared between the two groups at baseline（T0）,immediately after intubation（T1） and the peak value of after intubation and before general anesthesia,and intubation quality indicators were compared.Result：The peak amplitude of BP and HR in the low concentration group before intubation was higher than that in the high concentration group,and the difference was statistically significant（P〈0.05）.The intubation time of high-concentration group was（34.3±10.1）s,shorter than the low-concentration group（56.5±15.3）s,the difference was statistically significant（P〈0.05）.The catheterization success rate of high-concentration group was 100,higher than 87.67% in the low-concentration group,the incidence of cough and complication rate of intubation in the high-concentration group were 0 and 4.11%,lower than 8.22% and 15.07% in the low-concentration group,the difference were statistically significant（P〈0.05）.Conclusion：2% Lidocaine has better anesthetic effect,which helps to reduce the negative effect of intubation and stabilize circulation.
出处
《中外医学研究》
2017年第33期8-10,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
保留呼吸气管插管
利多卡因
并发症
Retention respiration intubation
Lidocaine
Complication
