氟比洛芬酯与利多卡因联合应用对高血压患者腹腔镜下胆囊切除术的影响

目的 以维持全麻手术血流动力学平稳为目的，探讨氟比洛芬酯和利多卡因静脉联合应用对高血压患者血流动力学的影响。方法 选取2018年4月~6月在承德医学院附属医院择期行腹腔镜下胆囊切除术的高血压患者60例，随机分为实验组（F组）和对照组（C组），每组30例。F组在麻醉诱导前10 min静脉缓慢给予氟比洛芬酯50 mg和利多卡因1 mg/kg，并持续泵注利多卡因1 mg/（kg·h）至手术结束，C组给予等量生理盐水。观察两组患者手术时间、在入室时（T0）、插管时（T1）、切皮时（T2）、拔管时（T3）的平均动脉压（MAP）与心率（HR）的变化。记录两组插管时呛咳发生率与拔管时躁动发生率、苏醒时间、拔管时间。结果 两组患者的手术时间、苏醒时间、拔管时间比较，差异无统计学意义（P＞0.05）。C组在T1、T2、T3时的MAP和HR均高于F组，统计学意义显著（P＜0.01）。F组的插管时呛咳发生率与拔管时躁动发生率分别为10.00%和17.00%，均低于C组的40.00%和53.00%，统计学意义显著（P＜0.01）。结论 氟比洛芬酯与利多卡因联合应用于高血压患者腹腔镜下胆囊切除术，有利于维持血流动力学平稳，且不延长苏醒时间与拔管时间，还可减轻插管时呛咳发生率与拔管时躁动发生率。

Effect of Flurbiprofen Axetil Combined with Lidocaine on Laparoscopic Cholecystectomy in Patients with Hypertension

Objective To investigate the hemodynamics of hypertensive patients with the combination of flurbiprofen and lidocaine in order to maintain the hemodynamic stability of general anesthesia. Methods 60 patients with hypertension who underwent laparoscopic cholecystectomy at the Affiliated Hospital of Chengde Medical College from April to June 2018 were randomly divided into experimental group (F group) and control group (C group).30 cases in each group. In group F, flurbiprofen 50 mg and lidocaine 1 mg/kg were given intravenously 10 min before anesthesia induction, and lidocaine 1 mg/(kg·h) was continuously pumped to the end of the operation, and group C was given amount of saline. The changes in the mean arterial pressure (MAP) and heart rate (HR) of the operation time, the time of entry (T0), the time of intubation (T1), the time of incision (T2), and the time of extubation (T3) were observed. The incidence of coughing during intubation and the incidence of agitation during extubation, recovery time, and extubation time were recorded. Results There was no significant difference in the operation time, recovery time and extubation time between the two groups (P>0.05). The MAP and HR of group C were higher than those of group F at T1, T2 and T3, and the statistical significance was significant (P<0.01). The incidence of coughing during intubation and the incidence of agitation during extubation in group F were 10.00% and 17.00%, respectively, which were lower than 40.00% and 53.00% in group C, which was statistically significant (P<0.01). Conclusion Flurbiprofen axetil combined with lidocaine for laparoscopic cholecystectomy in patients with hypertension is beneficial to maintain hemodynamic stability, and does not prolong the recovery time and extubation time, but also relieve cough during intubation. The incidence rate and the incidence of agitation during extubation.