盐酸利多卡因胶浆在经喉罩自主通气患者中的应用

目的观察盐酸利多卡因胶浆涂抹于喉罩表面及患者口咽部放置喉罩对自主通气患者的临床效果。方法随机将60例乳房肿块区段切除术患者分利多卡因胶浆组（观察组，n=30）和石蜡油组（对照组，n=30）。观察组麻醉前3min含服盐酸利多卡因胶浆5mL，剩余涂抹于喉罩表面，对照组将利多卡因胶浆换成等量石蜡油，待患者入睡后将喉罩置人。记录两组患者麻醉前5min（T0）、置喉罩时（T1）、置喉罩后5min（T2）、术始15min（T3）、拔喉罩时（T4）、拔喉罩后5min（T5）的MAP和HR以及术中、术后不良反应。结果组间比较，MAP在T2、T3和T4，HR在T1、T4差异均有统计学意义（均P〈0．05）；组内MAP与T0比较，对照组T1降低，T3、T4升高，观察组T1、T2降低，HR与rr0比较，对照组T3、T4升高，差异均有统计学意义（均P〈0．05）；术中吞吐反应、术后咽痛的发生率观察组均低于对照组，组间比较差异有统计学意义（P〈0．01）。结论盐酸利多卡因胶浆可明显减少置喉罩自主通气患者术中循环波动和术后咽喉疼痛的发生。

Application of lidocaine hydrochloride mucilage on patients with laryngeal mask spontaneous ventilation

Objective To observe the effect of lidocaine hydrochloride plasmagel daubing laryngeal mask airway （LMA） and throat of patients with breathing spontaneously during general anaesthesia. Methods A total of 60 patients treated with breast lumps segment resection were divided into lidocaine mucilage group （observation group, n=30） and paraffin group （control group, n=30） randomly. The observation group patients sublingual hydrochloride mucilage 5 mL at 3 minutes before anesthesia, and the LMA smeared with lidocaine hydrochloride mucilage was inserted while the LMA smeared with paraffin oil was inserted in control group when they all asleep. The mean arterial pressure and heart rat were recorded at 5min before induction （To）, when insert of LMA （T1）, 5 min after LMA inserted （T2）, 15min after the beginning of operation （T3）, when removal of LMA （T4）, and 5 rain after LMA removed （Ts）. The incidence of adverse reactions during operation and postoperative were record as well. Results Compared with control group, mean arterial pressure and heart rat of observation group decreased significantly at T3 and T4, and mean arterial pressure was lower at T2 （P〈0.05）. In control group, compared with To, the mean arterial pressure was lower at T,, and higher at T3 and T4. In observation group, the mean arterial pressure was lower at TI and T2. Compared with To, the heart rat was higher at T3 and T~ in control group （P〈0.05）. The incidence of swallowing reaction during operation and postoperative sore throat was higher in control group （P〈0.01）. Conclusion Lidocaine hydrochloride mucilage can reduce hemodynamics variation and incidence of postoperative anginose in patients breathing spontaneously during general anaesthesia.