利多卡因在支撑喉镜手术中对血流动力学的影响

目的 观察利多卡因不同给药方式对支撑喉镜手术中患者血流动力学的影响.方法 选择75例择期行支撑喉镜下声带息肉、会厌或喉肿物摘除活检的全麻成年患者.随机分成三组,每组25例.Ⅰ组为对照组；Ⅱ组为喷喉组；Ⅲ组为静脉用药组.观察患者手术期间呛咳的发生率和平均动脉压（MAP）、心率（HR）的变化.结果 Ⅱ组呛咳发生率低于Ⅰ组和Ⅲ组（P＜0.05）.Ⅱ组拔除导管时MAP、HR低于Ⅰ组和Ⅲ组（均P＜0.05）.Ⅰ组和Ⅲ组拔除导管时MAP、HR差异均无统计学意义（均P＞0.05）.结论 利多卡因充分喷喉对预防和减轻支撑喉镜手术中患者呛咳和心血管反应有明显作用,其效果优于利多卡因静脉内用药.

The effect of lidocaine on hemodynamics in self-retaining laryngoscope

Objective To observe the different mode of administration of lidocaine on hemodynamic effects during self-retaining laryngoscope.Methods 75 adult patients,underwent selective operations of removal and biopsy of the vocal polype,epiglottis or laryngeal tumor via self-retaining laryngoscope under general anesthesia,were randomly divided into three groups,with 25 cases for each.Group Ⅰ was the control group; Group Ⅱ was the throat spraying group;Group Ⅲ was the intravenous drug group.The incidence of irritating cough and the changes of mean arterial pressure(MAP) and hear rate(HR) were observed during operations.Results The incidence of irritating cough in group Ⅱ was lower than in group Ⅰ and group Ⅲ ( all P ＜ 0.05 ).MAP,HR in group Ⅱ was also lower than that in group Ⅰ and Ⅲ during extubation( all P ＜0.05).However there were no significant differences on MAP,HR between group Ⅰ and group Ⅲ during extubation( all P ＞ 0.05 ).Conclusion Lidocaine spraying on larynx could alleviate irritating cough and had significant preventive effect on cardiovascular response,and the effect in this method was superior to intravenous injection.