【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2 g),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1 min两组间收缩压与心率乘积,L组(12 867±2 169)低于C组(16 385±2 242)(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。更多还原

【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 Lat 1 min after extubation( P < 0. 05). Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia.更多还原