局部利多卡因凝胶与静脉注射利多卡因在喉罩应用中的比较研究

目的探讨在喉罩使用过程中局部利多卡因凝胶与静脉注射利多卡因对维持血流动力学的稳定性是否有相同效应。方法选择2011年6月～2012年10月择期全麻下腹腔镜胆囊切除术48例，随机分为3组，每组16例。T组（局部给药组），2％利多卡因凝胶涂抹于喉罩罩杯的双面，同时静脉注射生理盐水10ml；1组（静脉给药组），普通水溶性润滑剂涂抹于喉罩罩杯的双面，同时2％利多卡因1．5mg／kg生理盐水稀释至10ml静脉注射；C组（对照组），普通水溶性润滑剂涂抹于喉罩罩杯的双面，同时生理盐水10ml静脉注射。记录喉罩置入前，置入即刻，置入后1、3、5min，以及拔除喉罩前1min，拔除即刻，拔除后1、3、5min的平均动脉压（MAP）、心率（HR），记录拔除喉罩前后并发症。结果3组置入和拔出喉罩时MAP、HR无明显变化（P〉0．05）。T组和I组MAP在喉罩置入后1min和拔出即刻、1min、3min、5min明显低于C组（P〈0．05）。拔除喉罩后3组均无喉痉挛和吞咽困难发生，咽痛、干呕并发症发生率3组差异无显著性（P〉0．05）。结论局部应用利多卡因凝胶与静脉注射利多卡因在喉罩使用过程中对维持血流动力学的稳定性具有相同效应。

A Comparison of Topical Use of Lidocaine Gel and Intravenous Lidocaine in the Application of Laryngeal Mask

Objective To discuss the safety of topical use of lidocaine gel and intravenous lidocaine in the application of laryngeal mask. Methods A group of 48 cases of laparoscopic cholecystectomy performed under general anesthesia from June 2011 to October 2012 were randomly divided into 3 groups, with 16 cases in each group. The group T （Topical treatment group） was given 2% lidocaine gel onto both sides of laryngeal mask, with 10 ml of intravenous 0.9% saline solution. The group I （ Intravenous treatment group） was given common water-soluble lubricant onto both sides of laryngeal mask, with intravenous injection of 10 ml of 2% lidocaine and 1.5 mg/kg saline dilution. The group C （Control group） was given common water-soluble lubricant onto both sides of laryngeal mask, with intravenous administration of 10 ml 0.9% saline solution. The mean artery pressure （MAP） , heart rate （HR）, and complications before and after mask removal were recorded at before mask application, 0, 1, 3, 5 min after mask placement, 1 min before mask removal, and 0, 1, 3, 5 rain after mask removal, respectively. Results There was no significant difference between the three groups in MAP and HR at the time of laryngeal mask placement and removal （ P 〉 0.05）. The group T and group I had significant difference as compared with the group C （ P 〈 0.05） in MAP at time points of mask placement and 0, 1, 3, 5 min after mask removal. There was no significant difference between the three groups in complications after the removal of laryngeal mask （ P 〉 0. 05 ）. Conclusion Both topical application of lidocaine gel and intravenous use of lidocaine are safe in the application of laryngeal mask.