Soldatsky Yu L, Denisova O A, Mazur E M
N.I. Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia, 117997; Morozovskaya City Children's Clinical Hospital, Moscow Health Department, Moscow, Russia, 119049.
Morozovskaya City Children's Clinical Hospital, Moscow Health Department, Moscow, Russia, 119049.
Vestn Otorinolaringol. 2015;80(5):51-55. doi: 10.17116/otorino201580551-55.
This prospective randomized study with double blind control was designed to evaluate the effectiveness of various anesthetic techniques employed prior to fibroendoscopy of the nose, nasopharynx, and larynx of the children. The study included 160 children at the age varying from 3 to 14 (mean 7.4±2.96) years randomly allocated to four statistically comparable groups matched for age and sex. The following preparations were used to treat the children prior to fibroendoscopy: physiological solution (group 1), a 0.05% xylometazoline solution (group 2), a 10% lidocaine solution (group 3), and a mixture of 0.05% xylometazoline and 10% lidocaine solutions (group 4). The evaluation of the tolerance to the pretreatment of the nasal cavity with lidocaine and lidocaine plus xylometazoline (groups 3 and 4) showed that it was significantly (p<0.05) worse than in groups 1 and 2. The subjective tolerance to fibroendoscopy as reported by the patients was on the average similar in the children of all four groups (p>0.05). The doctors found the tolerance of fibroendoscopy to be the worst following pretreatment with the physiological solution (group 1) and the best after pretreatment with a mixture of lidocaine and xylometazoline (group 4) (p=0.03). The children comprising groups 2 and 3 were not significantly different in terms of the tolerance to fibroendoscopy (p>0.05). It is concluded that the pretreatment of the nasal cavity of the children with a 10% lidocaine solution before fibroendoscopy has no advantage over the pretreatment with a 0.05% xylometazoline solution; at the same time, insuflation of lidocaine as an anesthetic induces more pronounced negative emotions compared with the application of 0.05% xylometazoline.
这项前瞻性随机双盲对照研究旨在评估在儿童鼻、鼻咽和喉纤维内镜检查前采用的各种麻醉技术的有效性。该研究纳入了160名年龄在3至14岁（平均7.4±2.96岁）的儿童，随机分为四个在年龄和性别上具有统计学可比性的组。在纤维内镜检查前，采用以下制剂对儿童进行治疗：生理盐水（第1组）、0.05%赛洛唑啉溶液（第2组）、10%利多卡因溶液（第3组）以及0.05%赛洛唑啉和10%利多卡因溶液的混合物（第4组）。对利多卡因和利多卡因加赛洛唑啉预处理鼻腔的耐受性评估（第3组和第4组）显示，其明显（p<0.05）比第1组和第2组差。所有四组儿童报告的对纤维内镜检查的主观耐受性平均相似（p>0.05）。医生发现，纤维内镜检查的耐受性在生理盐水预处理后（第1组）最差，在利多卡因和赛洛唑啉混合物预处理后（第4组）最佳（p=0.03）。第2组和第3组儿童在纤维内镜检查耐受性方面无显著差异（p>0.05）。结论是，在纤维内镜检查前用10%利多卡因溶液预处理儿童鼻腔并不比用0.05%赛洛唑啉溶液预处理更具优势；同时，与应用0.05%赛洛唑啉相比，注入利多卡因作为麻醉剂会引发更明显的负面情绪。
