摘要
目的观察2%甲哌卡因喷喉联合5%复合利多卡因乳膏喉罩润滑在老年患者喉罩全麻中的效果。方法随机选择2018年7月至2019年12月本院ASA分级Ⅱ或Ⅲ级拟喉罩全麻下行经尿道输尿管镜钬激光碎石术老年患者60例,按照随机数字表法分为两组,每组30例。对照组患者在喉罩尖端和背部涂上复方利多卡因乳膏2 g后进行喉罩置入,接呼吸机机械通气;实验组患者麻醉诱导前用2%的甲哌卡因溶液行咽喉黏膜喷雾表面麻醉,5 min后诱导方法和麻醉维持与对照组相同。观察并记录两组患者入手术室麻醉前(T0),喉罩置入前1 min(T1),置入即刻(T2),置入后3 min(T3),喉罩拔除前1 min(T4)和拔除时(T5)的MBP、HR变化及术后24 h不良反应(包括喉罩拔除时躁动、呛咳,拔除后咽喉不适)发生率。结果实验组T2、T3、T4、T5时的MBP、HR变化均小于对照组(P<0.05),且喉罩拔除时躁动、呛咳及术后24h患者咽喉不适的发生率明显低于对照组(P<0.05)。结论 2%甲哌卡因喷喉联合5%复合利多卡因乳膏喉罩润滑用于老年患者喉罩全麻中,可有效抑制喉罩引起的心血管反应、躁动及呛咳,同时减少术后咽喉不适发生率,具有良好的临床应用价值。
Objective To observe the effect of 2%mepivacaine combined with 5%compound lidocaine cream in elderly patients under general anesthesia with laryngeal mask airway.Methods 60 ASAⅡorⅢelderly patients undergoing selective lexible ureteroscopic lithotripsy with laryngeal mask airway general anesthesia from July 2018 to December 2019 were randomly divided into two groups according to random number table method,with 30 cases in each group.The patients in the control group were treated with 2 g compound lidocaine cream on the tip and back of LMA,and then the laryngeal mask was implanted and mechanical ventilation was performed.The patients in the experimental group were treated with 2%mepivacaine solution for spray anesthesia before the induction of anesthesia.After 5 min,the induction method was the same as that in the control group.The changes of MBP and HR were recorded at the time of before anesthesia(T0),1 min before inserting laryngeal mask(T1),inserting laryngeal mask(T2),3 min after inserting laryngeal mask(T3),1 min before removing the laryngeal mask(T4)and removing the laryngeal mask(T5).The incidence of adverse reactions in postoperative 24 h were observed,including restlessness,choking cough,and throat discomfort.Results The changes of MBP and HR at the time of T2,T3,T4,T5 in the experimental group were smaller than those in the control group(P<0.05).The incidence of adverse reactions in postoperative 24 h were significantly lower than that in the control group(P<0.05).Conclusion 2%mepivacaine combined with 5%compound lidocaine cream for topical anesthesia can effectively inhibit the cardiovascular response,restlessness and cough caused by laryngeal mask,and reduce the incidence of postoperative laryngeal discomfort,has good clinical application value.
作者
杨雪莹
张雪荣
徐永腾
Yang Xueying;Zhang Xuerong;Xu Yongteng(Department of Anesthesialogy,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong,510120,China;Department of Neurology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong,510120,China)
出处
《当代医学》
2020年第31期1-3,共3页
Contemporary Medicine
基金
国家自然科学基金项目(81801229)。
