复方利多卡因乳膏对小儿腹部手术全麻拔管的影响

目的：探讨复方利多卡因乳膏涂于气管导管表面对小儿腹部手术拔管的安全影响。方法：选择60例5～12岁患儿的腹部手术，随机分两组，实验组麻醉前用复方利多卡因乳膏涂于气管导管套囊表面，对照组插入同型号的气管导管，但不使用复方利多卡因乳膏。观察两组插管和拔管时心率（HR）、血氧饱和度（SpO2）、呼气末CO2浓度或分压（PETCO2）及拔管时间的变化，以及麻醉苏醒后患儿对气管导管的耐受情况，术后第2天随访声嘶和谵妄的发生率以及术后24h的引流量。结果：两组患儿在麻醉作用消失后，实验组患儿能较好地耐受气管导管，生命体征平稳，而对照组耐受气管导管差。术后第2天随访，实验组嘶和谵妄发生率以及术后24h的引流量明显低于对照组，差异具有统计学意义（P〈0．05）。结论：复方利多卡因乳膏涂于气管导管表面用于小儿下腹部手术的麻醉能减轻气管导管在拔管时的应激反应，术后声嘶及谵妄发生率低，提高小儿腹部手术麻醉在拔管时的安全性。

Effects of compound lidocaine cream in the endotracheal tube extuba- tion of pediatric abdominal surgery under general anesthesia

AIM： To evaluate the surface an- esthetic effects of compound lidocaine cream-coa- ted endotracheal tube for pediatric abdominal surgery extubation security. METHODS： Sixty 5-12 years old children undergoing abdominal operation under general anesthesia received in- sertion of the endotracheal tube coated with ei- ther compound lidocaine cream （experimental group） or nothing（control group）. Pulse Oxygen Saturation （SpO2）,heart rate（HR） and the re- spiratory end of carbon dioxide （PET CO2） were measured during intubation and extubation. Postoperative pediatric endotracheal tube toler- ance and respiratory reaction after anesthesia was recorded. RESULTS：After the two groups of children in the anesthetic effect disappear, com- pared with the control group, experimentalgroup can be better tolerated endotracheal tube, stable vital signs;the next day, the hoarseness and delirium incidence in experimental group were significantly lower, there was statistically significant difference （P 〈 0.05） . CONCLU- SION. Compound lidocaine cream-coated endo- tracheal tube can inhibit the stress response of the endotracheal tube extubation, with lower postoperative hoarseness and delirium , can im- prove the safety of anesthesia extubation in children undergoing abdominal operation under gen eral anesthesia.