复方利多卡因乳膏用于气管表面麻醉对应激反应的影响

目的 观察复方利多卡因乳膏用于气管表面麻醉对应激反应的影响.方法 60例ASAⅠ～Ⅱ级拟行腹腔镜胆囊切除术手术患者使用信封法随机分成两组.试验组用复方利多卡因乳膏2.5 g均匀涂于气管导管的套囊及前端 对照组使用等量白色医用凡士林涂于气管导管的套囊及前端,麻醉诱导后行气管内插管.于诱导前和患者术后呼之睁眼时采集静脉血检测血浆促肾上腺皮质激素、皮质醇及血糖水平 同时记录该时点的收缩压、平均动脉压、舒张压和心率.结果 试验组术后较术前平均动脉压、舒张压、心率、血糖和促肾上腺皮质激素无明显变化,无统计学意义（P〉0.05） 对照组上述指标在两时点均明显增加,有统计学意义（P〈0.05）.收缩压和皮质醇在两组前后比较均有统计学差异（P〈0.05）,但对照组组更显著（P〈0.01）.结论 复方利多卡因乳膏用于气管表面麻醉可抑制拔管期间的应激反应,明显减小血流动力学的波动.

Effect of stress responses to endotracheal surface anesthesia using compound lidocaine cream

Objective To observe the effect of stress responses to endotracheal surface anesthesia using compound lidocaine cream. Methods Sixty ASA Ⅰ - Ⅱ patients arranged for laparoscope eholeeysteetomy were randomly divided into two groups. Trial group （ Lidocaine group, n = 30 ） smeared evenly compound lidocaine cream （ 2.5 g） over tracheal tube before anesthesia induction, control group used the same dose medical Vaseline. Sera adrenocortieotropic hormone（ ACTH）, cortisone and blood glucose were measured before anesthesia induction and after surgery when patients could open their eyes. Systolic blood pressure（ SBP）, mean arterial pressure（ MAP）, diastolic blood pressure（DBP） and heart rate（HR） were recorded at the same time. Results Compared within groups, trial group had no difference in mean arterial pressure, diastolic blood pressure, heart rate, blood glucose and adrenoeortieotrepic hormone; but control group had much difference in these indexes. There were difference in systolic blood pressure and cortisone in both groups, but it＇s more apparent in control group. Conclusion Endotracheal surface anesthesia using compound lidocaine cream could depress stress responses during tracheal extubation period and decrease the fluctuation of hemodynamics.