表麻型气管导管对老年高血压患者全麻拔管心血管反应的影响

【目的】探讨经表麻型气管导管气管黏膜表面麻醉对老年高血压患者拔管时心血管反应的影响。【方法】将180例老年高血压择期手术患者分为6组，每组30例。A、A’组：使用表麻型气管导管，拔管前注入2％利多卡因2ml；B、B’组：普通气管导管套囊外涂抹2％利多卡因凝胶；C、C’组：为对照组，无任何表面麻醉；其中，A、B、C组手术时间小于2h，A’、B’、C’组手术时间大于2h。观察指标：记录血压、心率的基础值、手术结束即刻、拔管时、拔管后1、3、5min的变化，并计算RPP（HRxSBP）。【结果】手术时间〈2h时，两种表麻方式在拔管即刻和拔管后不同时点与对照组比较有很好的减少循环波动的保护作用，差异有统计学意义（P〈0．01）；手术时间〉2h时，经表麻型气管导管内表面麻醉，在拔管即刻和拔管后不同时点与利多卡因凝胶组比较有很好的减少循环波动的保护作用，差异有统计学意义（P〈0．01）。【结论】经表麻型气管导管行气管内表面麻醉，是防止老年高血压患者拔管期心血管反应的最好方法。

Effect of avoiding hemodynamic fluctuation in using surface anaesthetic tracheal tube in geriatric hypertensive

Objective] To investigate the effect of tracheal mucosal surface anaesthetic tracheal tube on tracheal extubation response of tracheal tube in geriatric hypertensive. Methods] One hundred and eighty geriatric hypertensive undergoing selective operations were randomly divided into 6 groups with 30 patients each group. Each patient was intubated with a surface anaesthetic tracheal tube and squirted 2% hdocaine 2 ml before extubation in group A and A＇, with a commonly tracheal tube smeared 2% lidocaine gel over its balloon in group B and B＇, in group C and C＇was no surface anesthesia as control group. The operation duration was short of 2 hours in group A, B , C and the duration was longer than 2 hours in group A＇, B＇, C＇. Mean arterial pressure （MAP） and heart rate （HR） were recorded before intubation. RPP （HR x SBP ） was computed . Results] There were much different degrees on protection effection against Hemodynamic fluctuation among two surface anaesthetic groups with control group （ P 〈 0. 01 ） and surface anaesthetic tracheal tube group with hdoeaine gel group. Conclusions] Tobe used surface anaesthetic tracheal tube in geriatric hypertensive is the most ideal methods of avoiding Hemodynamic fluctuation.