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复方利多卡因乳膏抑制脑动脉瘤夹闭术后气管拔管期心血管反应的效果

胡伟,李金玉   

  1. 南京医科大学附属淮安第一医院麻醉科
  • 收稿日期:2012-11-26 修回日期:2013-02-23 出版日期:2013-09-15 发布日期:2013-09-15
  • 通讯作者: 胡伟

Effect of compound lidocaine cream inhibit the cardiovascular responses of extubation after the Cerebral aneurysm clipping surgery

  • Received:2012-11-26 Revised:2013-02-23 Published:2013-09-15 Online:2013-09-15
  • Contact: Wei Hu

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摘要：

【摘要】目的   观察复方利多卡因乳膏抑制脑动脉瘤夹闭术后气管拔管期间心血管反应的临床效果。方法   脑动脉瘤夹闭手术32例（ASAⅠ～Ⅱ级），随机分为复方利多卡因乳膏组（L组）和对照组（C组），每组16例。L组于气管插管前涂布5%复方利多卡因乳膏于气管导管前端，C组涂布等量凡士林。记录手术时间、麻醉时间、瑞芬太尼用量、术中补液总量。记录麻醉前（T1）、拔管前2min（T2）、拔管时即刻（T3）、拔管后2min（T4）患者收缩压（SBP）、舒张压（DBP）、心率（HR）。计算2组T3时点与T2时点的SBP、DBP、HR差值（△SBP、△DBP、△HR），并计算差值与T2时点相应数据的比值。结果  L组T3、T4时点SBP、DBP、HR显著低于C组（P<0. 05）。L组△SBP、△DBP、△HR及差值与T2时点相应数据的比值显著低于C组（P<0.05）。 结论  脑动脉瘤夹闭手术插管前气管导管涂布复方利多卡因乳膏可有效抑制术后拔管期心血管反应

关键词: 颅内动脉瘤, 插管法, 气管内, 利多卡因, 丙胺卡因, 脑动脉瘤夹闭, 拔管, 心血管反应

Abstract: Objective To observe clinical effect of the compound lidocaine cream to inhibit the cardiovascular responses of tracheal extubation after the cerebral aneurysm clipping surgery. Methods 32 patients (ASA I - II level) of cerebral aneurysm clipping surgery were randomly divided into lidocaine cream group (L) and the control group (C group), 16 cases in each group. L group was coated with 5% lidocaine cream in the front of the tracheal tube before intubation, group C coating the same amount of vaseline. Recorded two groups such as age, height, weight in general. Recorded operation time, anesthesia time, dosage of remifentanil, dosage of fluid replacement. The SBP, DBP, and HR of before anesthesia (T1), 2min before extubation (T2), extubation (T3), 2min after extubation (T4) in patients were recorded. Calculation of the two groups at T3and T2 to SBP and DBP, HR difference (ΔSBP, ΔDBP, ΔHR), and calculate the ratio of the difference between T2 to corresponding data. Results The SBP and DBP, HR in T3, T4point of group L significantly lower than group C (P <0 05). The ratio of ΔSBP, ΔDBP, ΔHR and the corresponding data of T2 of group L was significantly lower than group C (P <0 05). Conclusion Tracheal tube coated compound lidocaine cream before intubation can effectively inhibit the cardiovascular responses of extubation after cerebral aneurysm clipping surgery.

Key words: 心血管反应