10%利多卡因喷雾对悬雍垂喉镜检查和拔管时咳嗽引起的动脉压升高的影响。
Effects of 10% lidocaine spray on arterial pressure increase due to suspension laryngoscopy and cough during extubation.
机构信息
Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
出版信息
Korean J Anesthesiol. 2011 Jun;60(6):422-7. doi: 10.4097/kjae.2011.60.6.422. Epub 2011 Jun 17.
BACKGROUND
It is well known that suspension laryngoscopy (SL) produces marked hemodynamic changes. Coughing during extubation sometimes causes adverse clinical problems. We investigated whether 10% lidocaine spray could attenuate hemodynamic stress responses due to SL and reduce coughing incidence during extubation.
METHODS
Sixty patients undergoing SL were randomly divided into two groups and intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine, sprayed onto laryngeal and intratracheal sites 2 min prior to intubation (10% lidocaine group). Mean arterial pressure (MAP) and heart rates (HR) during SL and coughing incidence during extubation were recorded.
RESULTS
MAP at 2.5 and 5 min (P < 0.05) and HR at 2.5 min after SL (P < 0.01) were greater in the control group than in the 10% lidocaine group. The number of coughs decreased in the 10% lidocaine group compared to the control group during pre- (6.8 ± 3.2 vs 10.3 ± 4.4, P < 0.01) and post-extubation period of 5 min (4.0 ± 2.3 vs 6.2 ± 4.2, P < 0.05) and during the entire study period (10.8 ± 3.9 vs 16.5 ± 5.6, P < 0.001).
CONCLUSIONS
Preoperative laryngeal and intratracheal spraying with 1.5 mg/kg of 10% lidocaine spray is effective for attenuation of arterial pressure increase to SL and suppression of coughing during extubation.
背景
众所周知，悬雍垂喉镜检查（SL）会引起明显的血流动力学变化。拔管时咳嗽有时会引起不良的临床问题。我们研究了 10%利多卡因喷雾是否可以减轻因 SL 引起的血流动力学应激反应，并降低拔管时咳嗽的发生率。
方法
60 例接受 SL 的患者被随机分为两组，一组在无 10%利多卡因喷雾的情况下插管（对照组），另一组在插管前 2 分钟将 1.5mg/kg 的 10%利多卡因喷雾喷到喉部和气管内（10%利多卡因组）。记录 SL 期间的平均动脉压（MAP）和心率（HR）以及拔管期间咳嗽的发生率。
结果
与 10%利多卡因组相比，对照组在 SL 后 2.5 和 5 分钟时的 MAP（P < 0.05）和 SL 后 2.5 分钟时的 HR（P < 0.01）更高。与对照组相比，10%利多卡因组在预拔管期（6.8 ± 3.2 比 10.3 ± 4.4，P < 0.01）和拔管后 5 分钟（4.0 ± 2.3 比 6.2 ± 4.2，P < 0.05）以及整个研究期间（10.8 ± 3.9 比 16.5 ± 5.6，P < 0.001）的咳嗽次数减少。
结论
术前在喉部和气管内喷洒 1.5mg/kg 的 10%利多卡因喷雾可有效减轻 SL 引起的动脉压升高，并抑制拔管时咳嗽。
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