复方利多卡因乳膏预防全麻下声带息肉摘除术拔管反应的临床观察

目的观察复方利多卡因乳膏对支撑喉镜下行声带息肉摘除术患者全麻苏醒期反应的防治作用。方法40例择期全麻下行支撑喉镜下声带息肉摘除术患者，随机分为两组，每组20例。L组插管前在气管导管前1／3均匀涂抹复方利多卡因乳膏1～2g，C组用生理盐水润滑气管导管前1／3。两组麻醉诱导和维持用药相同。观察麻醉诱导前（T0）、吸痰时（T1）、拔管时（T2）、拔管后2min（T3）、拔管后5min（T4）的HR和SBP、DBP；拔出气管导管前做套囊充气放气试验2～3次，观察患者有无呛咳反应，观察拔管后患者屏气和躁动发生情况。结果与C组相比，L组的I-IR、SBP、DBP在T1～T3时点明显降低（P〈0，05）。C组患者出现呛咳反应的发生率明显高于L组（P〈0．01），屏氢厘应和术后躁动的发生率也高于L组（P〈0．05）。结论复方利多卡因乳膏可以减轻支撑喉镜下行声带息肉摘除术患者全麻苏醒期的拔管反应。

Clinical observation of prevention from accident on extubation after general anesthesia by compound lidocaine cream in the vocal cord polypectomy

Objective To observe the effect of compound lidocaine cream alleviates accident during stage of analepsia in the vocal cord polypectomy under the suspension laryngoscope. Methods Forty patients scheduled for removing the vo- cal cord polyp were randomly divided into two groups（ n = 20 each） ：group L smeared evenly compound lidocaine cream（ 1 - 2 g） over tracheal tube before anesthesia induction, group C coated with the same dose saline water. The medication was same used for anesthesia induction and maintenance between two groups. BP and HR were recorded before induction （ T0 ）, aspiration of sputum （ T1 ） , extubation （ T2 ） ,2 rain after extubation （ T3 ） ,5 rain after extubation （ T4 ） ; The trial that cuff of endotracheal tube was inflated then deflated was manipulated 2 - 3 times before extubation, It was observeded that bucking was or not evoked. The matters about breathholding and restlessness were recorded. Results HR, SBP and DBP of patients at T1, T2,T3 were lower in group L than those in group C （P 〈 0. 05 ）. And the numbers of patients with bucking breathholding and restless- ness during extubation was significantly more in group C than group L（ P 〈 0.01 ）, meanwhile the breathholding and restlessness were also more than group C （ P 〈 0.05 ）. Conclusion Compound lidocaine cream attenuates adverse events during extubation in the vocal cord polypectomy under the suspension laryngoscope.