气管内应用利多卡因减轻全麻苏醒期的循环波动及呛咳反应

目的研究气管内单次或持续泵注利多卡因和静脉注射利多卡因对全麻苏醒拔管期气道及循环反应的影响。方法选择择期气管内全麻患者60例,ASA分级Ⅰ~Ⅱ级,随机分为4组,每组15例,术毕时分别给予相应药物,Ⅰ组为气管内持续泵注组;Ⅱ组为气管内单次给药组;Ⅲ组为静脉给药组;Ⅳ为对照组。观察拔管期血流动力学变化、呛咳反应情况和苏醒拔管时间。结果与Ⅳ组相比,Ⅰ、Ⅱ、Ⅲ组在吸痰时的血流动力学更平稳,差异有统计学意义（P〈0.05）;Ⅰ、Ⅱ组与Ⅳ组相比,Ⅰ组与Ⅲ组相比,呛咳反应差异有统计学意义（P〈0.05）。结论全麻苏醒期气管内给予利多卡因能够有效抑制气道机械刺激引起的循环波动及呛咳反应。

Attenuation of coughing and hemodynamics fluctuation to tracheal extubation: comparison of intratracheal lidocaine and intravenous lidocaine

Objective To study the effect of intratracheal lidocaine and intravenous lidocaine on the hemodynamics fluctuation and coughing incidence during the period of tracheal extubation. Methods In a double-blind and random study,60 patients（ASA Ⅰ-Ⅱ） under general anesthesia were divided into 4 groups（n=15 for each）.At the end of surgery,patients in group Ⅰ were given 2% lidocaine 1 mg/kg intratracheally and then maintained by the speed of 1 mg/（kg·h） until extubation;the patients in group Ⅱ,Ⅲ,Ⅳ were given 2% lidocaine 1 mg/kg intratracheally,2% lidocaine 1 mg/kg intravenously,normal saline 0.05 mL/kg intratracheally respectively.Results Compared with group Ⅳ,the hemodynamics of groupⅠ,Ⅱ,Ⅲ were more stable during suction（P0.05）.Compared with group Ⅳ,the incidence of coughing was decreased in group Ⅰ and group Ⅱ（P0.05）.Conclusions Intratracheal lidocaine effectively inhibits hemodynamics fluctuations to airway stimulation and significantly reduces the incidence of coughing during emergence for anesthesia.