高氧雾化吸入利多卡因在小儿支气管异物取出术中的应用

目的 比较小儿气管异物取出术时，采用高氧雾化吸入利多卡因表面麻醉法或丁卡因咽喉部喷雾法，何者更有利于抑制气道反射。方法 将拟行气管异物取出术的患儿随机分为两组,每组30例, 两组均采用静脉诱导麻醉，A组以利多卡因高氧雾化吸入，B组以丁卡因咽喉喷雾为气道表面麻醉，观察术中患儿MAP、HP、SPO2的变化以及不良反应的发生率。结果 术中两组的MAP、HP、SPO2差异有统计学意义(P<0.01)。A组屏气、呛咳、气道痉挛的发生率明显低于B组(P<0.01)。结论 高氧雾化吸入利多卡因可将表面麻醉剂吸入咽喉、气管、支气管，避免器械刺激引起的迷走神经反射，能更有效地抑制气道反射，使小儿气管异物取出术患儿的血流动力学更趋平稳。

Application of Lidocaine air atomized by oxygen on the removal of bronchial foreign bodies in children

Objective To compare children with tracheal foreign body removal surgery, the inhalation of high oxygen surface anesthesia of lidocaine or tetracaine throat spray, which is more conducive to suppress airway reflex. Methods 60 cases were randomly divided into two groups, group A(n=30) was given nebulized lidocaine and group B(n=30) was given tetracaine spray. Patient′s differences in MAP, HR, SPO2 and adverse effects during the induction of anesthesia and bronchiacopy were observed. Results There were significant differences of MAP, HR and SPO2 between the two groups(P<0.01). While the rigid bronchoscope stayed inside the trachea, the rate of breath holding, tracheal irritation and spasm in group B was more common than group A (P<0.01). Conclusion In the removal of bronchial foreign bodies in children, nebulized lidocaine can effectively suppress the reflection of the trachea. Therefore, the operation can proceed smoothly.