摘要
目的:观察利多卡因乳膏用于甲状腺手术抑制术中气管导管及手术操作引起的应激反应和减轻术后呛咳、咽喉痛等并发症的效果。方法:40名行择期甲状腺腺瘤切除患者分为利多卡因乳膏组(L组)和对照组(C组),每组20例。L组在气管导管套囊外涂布利多卡因乳膏1.5 g;C组气管导管外不涂布任何药物。于插管前(T0)、插管时(T1)、拔管时(T2)、拔管后(T3)记录两组患者的收缩压(SBP)、舒张压(DBP)、心率(HR),记录在处理甲状腺过程中最高的SBP、DBP、HR。记录两组患者在拔管后发生呛咳的例数,术后24 h发生咽喉痛的例数以及切口引流量。结果:L组在T1、T2、T3时点以及处理甲状腺过程中最高的SBP、DBP、HR均低于C组(P<0.05);L组拔管后发生呛咳的例数及术后24 h发生咽喉痛的例数均少于C组(P<0.05);L组术后24 h切口引流量低于C组(P<0.05)。结论:套囊外利多卡因乳膏可减轻插入或拔除气管导管以及术中牵拉压迫气管引起的应激反应,并可减少拔管后呛咳的发生及由于呛咳引起的切口出血增多。
Objective：To observe the effects applying lidocaine cream to the endotracheal tube cuff on management of stress reaction, postoperative bucking and sore throat in procedure on the thyroid gland. Methods ： Forty patients undergoing selective thyroidectomy were allocated equally to groups of lidocaine cream application（ Group L） and controls（ Group C）. Spraying the endotracheal tube cuff with lidocaine cream （ 1.5 g） was used for group L, whereas ＇group C was free. Systolic blood pressure （SBP） ,diastolic blood pressure （DBP） and heart rate （HR） were main- tained before intubation （ To ） , at intubation （ Tl ）, at extubation （ T2 ） and after extubation （ T3 ） , respectively. The maximal levels of SBP, DBP and HR in procedure,volume of incision drainage and incidence of post-operative bucking and sore throat were also recorded in the two groups. Results ： SBP, DBP, HR at T1 , T2, T3 and the highest SBP, DBP, HR during operative procedure on the thyroid gland were significantly lower in group L than in group C （ P 〈 0.05 ）. The volume of incision drainage and incidence of postoperative bucking and sore throat were decreased in group L as compared with group C （ P 〈 0. 05 ）. Conclusion ： Spraying the endotracheal tube cuff with lidocaine cream for patients undergoing thyroidectomy can not only lessen stress reaction from trachea traction, intubation and extubation, but reduce the incidence of postoperative bucking and hemorrhage at the incision.
出处
《皖南医学院学报》
CAS
2013年第3期242-244,共3页
Journal of Wannan Medical College
