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Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty
引用本文:江来 万小健 许华 卞金俊 韩文军 朱新明 邓小明. Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty[J]. 中国人民解放军军医大学学报, 2007, 22(4): 230-233. DOI: 10.1016/S1000-1948(07)60046-X
作者姓名:江来 万小健 许华 卞金俊 韩文军 朱新明 邓小明
作者单位:Departments of Anaesthesiology and Intensive Care Unit, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
摘    要:
Objective:To evaluate the effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty. Methods: Sixty patients were randomly divided into 4 groups: In the control group patients were given saline; in the lidocaine group patients were given 1.0 mg/kg lidocaine ; in the diltiazem group patients were given 0. 2 mg/kg diltiazem; and in the lidocaine plus diltiazem group patients were given 1.0 mg/kg lidocaine and 0. 2 mg/kg diltiazem. These drugs were given 2 rain before tracheal extuhation. Values for SBP, DBP, and HR were recorded, on arriving at the operating room, immediately at the end of the surgery, at the time of injection of the study drugs, at tracheal extubation, at 1 min and 5 min after extubation. The quality of extubation according to the Sebel's grading scale were compared among the 4 groups. Results:During extubation in the control group HR, SBP and DBP increased significantly when compared to baseline levels. Both lidocaine (1.0 mg/kg) and diltiazem (0. 2 mg/kg) successfully alleviated these increases. The suppressive effect of diltiazem was greater than that of lidocaine. The combinative use of the two drugs minimized the increases. The administration of lidocaine significantly suppressed bucking or coughing compared with the other groups. Conclusions: The pressor responses and tachycardia occurring in patients with uvulopalatopharyngoplasty during emergence from anesthesia and tracheal extubation, can be easily blocked by a bolus dose of 1.0 mg/kg lidocaine, 0. 2 mg/kg diltiazem or the comhinative use of the two drugs. And the concurrent use of lidocaine and diltiazem alleviated the hemodynamic changes more obviously.

关 键 词:咽成形术  麻醉手术  心血管响应  利多卡因  麻醉剂
收稿时间:2007-05-31
修稿时间:2007-05-312007-07-03

Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalato-pharyngoplasty
JIANG Lai,WAN Xiao-jian,XU Hua,BIAN Jin-jun,HAN Wen-jun,ZHU Ke-ming,DENG Xiao-ming. Effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalato-pharyngoplasty[J]. Journal of Medical Colleges of PLA(China), 2007, 22(4): 230-233. DOI: 10.1016/S1000-1948(07)60046-X
Authors:JIANG Lai  WAN Xiao-jian  XU Hua  BIAN Jin-jun  HAN Wen-jun  ZHU Ke-ming  DENG Xiao-ming
Affiliation:Departments of Anaesthesiology and Intensive Care Unit, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Abstract:
ObjectiveTo evaluate the effect of diltiazem and lidocaine on arterial pressure or heart rate and the quality of extubation in patients undergoing uvulopalatopharyngoplasty. MethodsSixty patients were randomly divided into 4 groups In the control group patients were given saline; in the lidocaine group patients were given 1.0 mg/kg lidocaine; in the diltiazem group patients were given 0.2 mg/kg diltiazem; and in the lidocaine plus diltiazem group patients were given 1.0 mg/kg lidocaine and 0.2 mg/kg diltiazem. These drugs were given 2 min before tracheal extubation. Values for SBP, DBP, and HR were recorded, on arriving at the operating room, immediately at the end of the surgery, at the time of injection of the study drugs, at tracheal extubation, at 1 min and 5 min after extubation. The quality of extubation according to the Sebel's grading scale were compared among the 4 groups. ResultsDuring extubation in the control group HR, SBP and DBP increased significantly when compared to baseline levels. Both lidocaine (1.0 mg/kg) and diltiazem (0.2 mg/kg) successfully alleviated these increases. The suppressive effect of diltiazem was greater than that of lidocaine. The combinative use of the two drugs minimized the increases. The administration of lidocaine significantly suppressed bucking or coughing compared with the other groups. ConclusionsThe pressor responses and tachycardia occurring in patients with uvulopalatopharyngoplasty during emergence from anesthesia and tracheal extubation, can be easily blocked by a bolus dose of 1.0 mg/kg lidocaine, 0.2 mg/kg diltiazem or the combinative use of the two drugs. And the concurrent use of lidocaine and diltiazem alleviated the hemodynamic changes more obviously.
Keywords:uvulopalatopharyngoplasty  emergence from anesthesia  trachealextubation  cardiovascular responses  diltiazem  lidocaine
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