復(fù)方利多卡因乳膏與右美托咪定抑制全身麻醉拔管期嗆咳反應(yīng)效果比較

王婷 鄭詩 劉燕君 黃琳 劉美麗 胡琳

摘要 目的：探討復(fù)方利多卡因乳膏與右美托咪定抑制全身麻醉拔管期嗆咳反應(yīng)差異，指導(dǎo)臨床選擇合適的麻醉藥物。方法：收治甲狀腺手術(shù)患者120例，隨機(jī)分為L組、D組和對照組（C組）各40例。L組氣管導(dǎo)管前1/2和套囊表面均勻涂抹復(fù)方利多卡因乳膏，D組氣管導(dǎo)管表面涂抹液狀石蠟并從氣管插管后至手術(shù)結(jié)束前30 min持續(xù)靜脈滴注右美托咪定，C組氣管導(dǎo)管表面涂抹液狀石蠟。比較相關(guān)指標(biāo)。結(jié)果：L組和D組拔管期間嗆咳反應(yīng)發(fā)生率和血液動力學(xué)指標(biāo)明顯低于C組，且嗆咳反應(yīng)程度也明顯低于C組，差異有統(tǒng)計(jì)學(xué)意義（P

關(guān)鍵詞 利多卡因;軟膏;右美托咪定;麻醉

Comparison of the effect of compound Iidocaine cream and dexmedetomidine in inhibiting cough reaction duringextubation of general anesthesiaWang Ting，Zheng Shi，Liu Yanjun，Huang Lin，Liu Meilin，Hu Lin

Abstract Objective：To investigate the difference between compound lidocaine cream and dexmedetomidine in inhihiting coughresponse during extubation of general anesthesia，and to guide clinical selection of appropriate anesthesia drugs.Methods：120cases of thyroid surgery patients were selected，they were randomly divided into the L group，the D group and the control group（thegroup C）with 40 cases in each group.ln the group L，compound lidocaine cream was uniformly applied on the surface of theendotracheal tuhe l/2 and the thimble.ln the group D，liquid paraffin was applied on the surface of tracheal catheter anddexmedetomidine was continuously intravenously drip from the tracheal intubation t0 30 min before the end of surgery.The groupC tracheal catheters were coated with liquid paraffin，we compared the relevanc indicators.Results：The incidence andhemodynamic indexes of chokehold reaction in extubation period in the group L and the group D were significantly lower thanthose in the group C，and the degree of chokehold reaction was significantly lower than that in the group C，the difference wasstacistic.ally significant.Conc.lusion：Compound lidocaine cream can significantly reduce the incidence of postoperative adversereactions compared with dexmedetomidine.

Key words

Lidocaine：Ointmenc：Dexmedetomidine;Narcosis

為探討復(fù)方利多卡因乳膏與右美托咪定抑制全身麻醉拔管期嗆咳反應(yīng)差異，指導(dǎo)臨床選擇合適的麻醉藥物，2015年5月-2016年4月收治甲狀腺于術(shù)患者120例，對其麻醉情況進(jìn)行分析，現(xiàn)報(bào)告如下。

資料與方法

2015年5月-2016年4月收治甲狀腺手術(shù)患者120例，按照隨機(jī)數(shù)字表法分為L組、D組和C組（對照組）各40例。入選標(biāo)準(zhǔn)：①美國麻醉醫(yī)師協(xié)會（ASA）分級為I～Ⅱ級[1];②既往無局部麻醉藥過敏史，無高血壓及心臟病史，無哮喘、慢性支氣管炎病史。L組男22例，女18例;平均年齡（45.08±10.25）歲;體重指數(shù)（BMI） （23.56±4.12）kg/㎡;手術(shù)時(shí)間（106.23±21.38）min。D組男24例，女16例;平均年齡（46.71±9.21）歲;BMI（25.18±3.08）kg/㎡; 手術(shù)時(shí)間（106.38±21.82）min。C組男21例，女19例;平均年齡（48.62±8.76）歲;BMI（23.43±5.15）kg/㎡; 手術(shù)時(shí)間（108.09±19.32）min。三組一般資料比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。

治療方法：L組氣管導(dǎo)管前1/2和套囊表面均勻涂抹復(fù)方利多卡因乳膏;D組氣管導(dǎo)管表面涂抹液狀石蠟并從氣管插管后至手術(shù)結(jié)束前30 min持續(xù)靜脈滴注右美托咪定;C組氣管導(dǎo)管表面涂抹液狀石蠟。