复方利多卡因乳膏预防全麻术后躁动和咽喉疼痛的临床观察

目的：观察复方利多卡因乳膏在预防全麻术后躁动和咽喉疼痛方面的临床效果。方法：将我院200例按美国麻醉师协会（ASA）分级标准评为Ⅰ～Ⅱ级的拟行气管插管全麻择期手术患者随机均分为A组和B组,2组均以咪唑安定、舒芬太尼、罗库溴铵、依托咪酯乳剂诱导,七氟醚、丙泊酚、瑞芬太尼维持麻醉。A组气管插管前用复方利多卡因乳膏2～3g均匀涂抹于气管导管套囊及前端,麻醉后用复方利多卡因乳膏1.5～2g均匀涂抹于导尿管外侧辅助导尿;B组常规气管插管及导尿。观察记录2组患者自主呼吸恢复时间、呼之睁眼时间、拔管时间、躁动程度评级、身体舒适度评分、术后24h咽喉疼痛程度评级,并观察2组不良反应。结果：2组患者手术结束后,自主呼吸恢复时间、呼之睁眼时间及拔管时间差异无统计学意义（P〉0.05）;而躁动程度评级和术后24h咽喉疼痛程度评级A组显著低于B组,身体舒适度评分A组显著高于B组,差异均有统计学意义（P〈0.05）。2组患者均未见明显过敏反应和局麻药中毒发生。结论：复方利多卡因乳膏可有效预防和减轻全麻患者术后躁动和咽喉疼痛的发生,且不良反应轻微。

Clinical Observation of Prevention of Agitation and Throat Pain after General Anasethesia Operation with Compound Lidocaine Cream

OBJECTIVE：To investigate clinical efficacy of Compound lidocaine cream in preventing the agitation and throat pain after general anasethesia operation.METHODS：200 patients with ASAⅠ～Ⅱ undergoing operation with tracheal intubation under general anesthesia were randomly divided into group A and group B.Anesthesia were induced by midazolam,rocuronium,sufentanil and etomidate cream in both groups and maintained with propofol,remifentanil and sevoflurane.Compound lidocaine cream 2～3 g was applied on the cuff and front of tracheal tube before the intubation in group A,and cream 1.5～2 g was applied on the outside catheter after the anaesthetic.The traditional method of intubation and urine conduction was adopted in group B.The parameter were recorded in 2 groups,such as recovering time of spontaneous breath,time of eye opening at request,extubation time,the agitation level,body comfortable status（BCS）,and degree of throat pain in 24 h after the operation.And adverse drug reactions were observed in 2 groups.RESULTS：There was no significant differences in recovering time of spontaneous breath,time of eye opening at request,extubation time between the 2 groups at the end of operation（P0.05）.The degrees of agitation and throat pain in group A were significantly lower than in group B,and BCS of group A was significantly higher than that of group B,there was statistical significance（P0.05）.There was no obvious allergic reaction and local anesthetic intoxication in 2 groups.CONCLUSIONS：Compound lidocaine cream can significantly prevent and relieve agitation and throat pain after general anasethesia operation,and slight ADR have been found.