复方利多卡因乳膏涂抹气管导管表面预防甲状腺手术全麻拔管期呛咳躁动

基础医学与临床 ›› 2015, Vol. 35 ›› Issue (1): 86-89.

复方利多卡因乳膏涂抹气管导管表面预防甲状腺手术全麻拔管期呛咳躁动

桑诺尔¹,曲歌²,张秀华¹,罗爱伦³,黄宇光¹

1. 北京协和医院
2. 北京协和医院麻醉科
3. 中国医学科学院北京协和医学院北京协和医院麻醉科

收稿日期:2014-08-25 修回日期:2014-11-19 出版日期:2015-01-05 发布日期:2014-12-30
通讯作者: 曲歌 E-mail:qugepopcorn@126.com

Topical anesthetic effects of Compound Lidocaine Cream coated endotracheal tube to prevent cough and agitation during extubation in thyroidectomy under general anesthesia

Received:2014-08-25 Revised:2014-11-19 Online:2015-01-05 Published:2014-12-30

摘要/Abstract

摘要： 目的评价复方利多卡因乳膏涂抹于气管导管表面，用于全麻甲状腺手术气管黏膜表面麻醉的有效性。方法前瞻随机双盲对照研究，连续纳入北京协和医院42例甲状腺部分或全切手术患者，随机分为对照组（C组）和试验组（L组）。将L组气管导管前1/2和套囊表面均匀涂布复方利多卡因乳膏（约2g），C组导管表面涂抹石蜡油。研究终点为拔管期自发或诱发的（人为套囊放气充气）呛咳躁动事件。记录血流动力学指标，随访患者在麻醉恢复室（PACU）和住院期间并发症。结果拔管前的自发呛咳躁动率L组低于C组（15%和65%）（p<0.01）；套囊放气充气试验阳性率L组低于C组（35%和90%）（p<0.001）。带管期间发生血压或心率增加超过基线20%的发生率，L组有低于C组的趋势（1.65 ±1.26和5.57 ±2.06次/例）；拔管后1min两组间收缩压与心率乘积，L组（12867±2169）低于C组（16385±2242）（p<0.05）。结论对于全麻下甲状腺手术，气管导管表面涂抹复方利多卡因乳膏进行气管黏膜表面麻醉，能够有效减少全麻拔管期患者的呛咳和躁动，降低心血管应激。

关键词: 复方利多卡因乳膏, 表面麻醉, 甲状腺手术, 呛咳躁动

Abstract: Objective To evaluate the topical anesthetic effects of Compound Lidocaine Cream (CLC) coated endotracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia. Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously enrolled in this prospective double-blinded randomized controlled trial. Patients were randomized into two groups. Group L were intubated with endotracheal tube coated with CLC, while the control group, Group C with liquid paraffin. The end point of study was spontaneous or induced cough/agitation during extubation. Hemodynamic parameters and the consumption of opioids were recorded. Patients were followed for major complications during their stay in hospital. Results Spontaneous cough/agitation rate was lower in Group L than Group C (15% vs. 65%, p<0.01) ；so was induced cough/agitation (35% vs. 90%, p<0.001) ；the value of SBP×HR was lower in Group L at 1 min after extubation (p<0.05). Conclusion The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia.

Key words: Compound Lidocaine Cream, Topical anesthesia, thyroidectomy, cough/agitation

中图分类号:

R453.9

桑诺尔曲歌张秀华罗爱伦黄宇光. 复方利多卡因乳膏涂抹气管导管表面预防甲状腺手术全麻拔管期呛咳躁动[J]. 基础医学与临床, 2015, 35(1): 86-89.