气道内持续输注利多卡因预防颅脑手术拔管期应激反应的效果

目的：观察气管内持续泵注2％利多卡因对颅脑手术拔管期的影响。方法：颅脑手术患者100例,ASAⅠ-Ⅱ级,随机分为两组,每组50例,均采用静吸复合全麻,其中麻醉诱导和麻醉维持用药均相同：其中Ⅰ组气管内持续泵注2％利多卡因至手术结束（一种可持续泵注药物的特殊气管导管,流速3 ml/h）；Ⅱ组采用普通气管导管,并且气管内不给药。结果：Ⅰ组患者围术期血压、心率波动小于Ⅱ组（ P〈0.05）、清醒时间和气管导管拔管时间都明显缩短（P〈0.05）、拔管时呛咳、体动反应明显减少（P〈0.05）；Ⅱ组患者中5例在气管导管拔管后出现低氧血症（SpO2：〈95％）,与Ⅰ组相比差异有统计学意义（P〈0.05）。结论：气管内持续泵注2％利多卡因可有效预防颅脑手术术毕苏醒期气管导管拔管的血流动力学的剧烈波动和呛咳体动反应,苏醒更加迅速安全,值得在临床推广应用。

Effects of continuous infusion of lidocaine in trachea to prevent stress response during extubation period of craniocerebral operation

Objective：To investigate the effect of trachea continuous infusion 2% lidocaine on extubation of craniocerebral surgery. Methods：All 100 patients with craniocerebral operation （ ASA Ⅰ-Ⅱ） were randomly divided into two groups. All patients were treated with intravenous-inhalation general anesthesia and the same anesthesia drugs. After tracheal intubation,the group I were treated with continuous infusion 2% lidocaine till the end of operation （ self-made airway for sustainable drip liquid,the flow rate is 3 ml per hour） . The group II were treated with general endotracheal tube and no given any medicine. Results：The blood pressure and heat rate fluctuation in group I were significant （ P〈0.05） less than that of groupⅡ. Further,the time of awaking and the time of extubation in group Ⅰ were also significantly （ P〈0.05） less than that of groupⅡ. In group Ⅱ there were 5 cases had hypoxemia after the extubation （ SPO2〈90%） ,which was significantly different from that of group Ⅰ. Conclusions：The application of trachea continuous infusion 2% lidocaine can reduce the incidence of hemodynamic fluctuations and bucking during extubation of craniocerebral operation,and come to life more rapidly and more safely.So it should be widely applied.