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冠状动脉搭桥手术患者对喉镜检查和经口气管插管血流动力学反应的减弱:静脉注射吗啡和利多卡因与静脉注射吗啡和利多卡因喷雾的比较

Attenuation of haemodynamic response to laryngoscopy and oral endotracheal intubation in coronary artery bypass surgery patients: intravenous morphine and lidocaine versus intravenous morphine and lidocaine spray.

作者信息

Ul Islam Mujahid, Ahmad Imtiaz, Shah Ali Azmat, Islam Ansa

出版信息

J Ayub Med Coll Abbottabad. 2014 Jul-Sep;26(3):275-8.

Abstract

BACKGROUND

Sympathetic response associated with laryngoscopy and endotracheal intubation is recognized as a potential cause for a number of complications especially in coronary bypass surgery patients. Various methods have been used to attenuate these hemodynamic responses, The aim of our study was to compare lidocaine spray in addition to intravenous morphine on attenuating the hemodynamic response to laryngoscopy and endotracheal intubation with intravenous lidocaine and morphine in coronary artery bypass surgery patients.

METHOD

Sixty patients, scheduled for elective coronary bypass grafting surgery were included in this randomized controlled trial. The patients randomly divided in group-A (Intravenous Morphine 0.1mg/kg and Intravenous lidocaine 1.5 mg/kg) and group-B (Intravenous Morphine 0.1mg/kg and lidocaine spray 1.5 mg/kg).

RESULTS

Demographic data was comparable in both groups. There was no statistically significant difference between two groups in the duration of laryngoscopy and intubation. There was statistically insignificant attenuation in heart rate in both groups (p=0.134), the trends of attenuation of systolic blood pressure, diastolic blood pressure and mean arterial pressure in group-A compared to group-B (p=0.933), (p=0.768) and (p=0.136) respectively were statistically insignificant.

CONCLUSIONS

Under the present study design, lidocaine spray in addition to intravenous morphine had no better effect on attenuating the hemodynamic response to laryngoscopy and endotracheal intubation as compared to intravenous lidocaine and morphine in coronary artery bypass surgery patients.

摘要

背景

与喉镜检查和气管插管相关的交感神经反应被认为是多种并发症的潜在原因,尤其是在冠状动脉搭桥手术患者中。已经使用了各种方法来减轻这些血流动力学反应。我们研究的目的是比较在冠状动脉搭桥手术患者中,静脉注射吗啡联合利多卡因喷雾与静脉注射利多卡因和吗啡在减轻喉镜检查和气管插管引起的血流动力学反应方面的效果。

方法

本随机对照试验纳入了60例计划进行择期冠状动脉搭桥手术的患者。患者被随机分为A组(静脉注射吗啡0.1mg/kg和静脉注射利多卡因1.5mg/kg)和B组(静脉注射吗啡0.1mg/kg和利多卡因喷雾1.5mg/kg)。

结果

两组的人口统计学数据具有可比性。两组在喉镜检查和插管持续时间上没有统计学显著差异。两组心率的衰减均无统计学意义(p=0.134),A组与B组相比,收缩压、舒张压和平均动脉压的衰减趋势分别为(p=0.933)、(p=0.768)和(p=0.136),均无统计学意义。

结论

在本研究设计下,在冠状动脉搭桥手术患者中,静脉注射吗啡联合利多卡因喷雾在减轻喉镜检查和气管插管引起的血流动力学反应方面,与静脉注射利多卡因和吗啡相比没有更好的效果。

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