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静脉注射与雾化吸入利多卡因对气管插管患者血流动力学反应的影响:一项随机临床试验

Effects of Intravenous and Inhaled Nebulized Lignocaine on the Hemodynamic Response of Endotracheal Intubation Patients: A Randomized Clinical Trial.

作者信息

Jokar Abolfazl, Babaei Maryam, Pourmatin Sahar, Taheri Majid, Almasi-Hashiani Amir, Yazdanbakhsh Arash

机构信息

Department of Medical Emergency, Arak University of Medical Sciences, Arak, Iran.

Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Essays Res. 2018 Jan-Mar;12(1):159-164. doi: 10.4103/aer.AER_75_17.

Abstract

BACKGROUND

Endotracheal intubation is one of the most common measures in the Intensive Care Unit (ICU) which plays an important role in airway management of the critically ill patients.

AIMS

The study aimed to evaluate the effects of lignocaine spray on hemodynamic response of endotracheal intubation patients.

SETTINGS AND DESIGN

This study is a randomized clinical trial on a study population comprising patients admitted to the ICU.

SUBJECTS AND METHODS

The patients were divided into three groups using a permuted block randomization. In Group 1, inhaled nebulized lignocaine 4% (75.0 mg/kg) was sprayed around the patients' epiglottis and larynx. In Group 2, intravenous (IV) lignocaine 2% (75.0/mg/kg) was injected. No lignocaine was prescribed for or administered to the control group. One and four minutes after intubation, the patients' hemodynamic and vital signs were measured.

STATISTICAL ANALYSIS USED

Data analysis was run using Stata 13 software through repeated measure ANOVA tests.

RESULTS

Although the mean arterial blood pressure (MAP) of Group 1 (inhaled nebulized lignocaine) was smaller than that of Group 2 (IV lignocaine), there was no significant difference between the two groups. Both groups' MAPs were significantly different from that of the control group. As for the average number of pulses, a significant difference was observed between the inhaled and IV lignocaine groups; hence, the average number of pulses in Group 1 (inhalation) was lower than that of Group 2 (IV injection).

CONCLUSION

As blood pressure is considered to be normal under 140/90 and may not entail any hemodynamic complications, it can be concluded that inhaled nebulized lignocaine can control the hemodynamic changes of intubation more effectively than IV lignocaine.

摘要

背景

气管插管是重症监护病房(ICU)最常见的措施之一,在危重症患者的气道管理中起着重要作用。

目的

本研究旨在评估利多卡因喷雾对气管插管患者血流动力学反应的影响。

设置与设计

本研究是一项针对入住ICU患者的随机临床试验。

研究对象与方法

采用置换区组随机化将患者分为三组。第1组,将4%(75.0mg/kg)雾化吸入利多卡因喷于患者会厌和喉部周围。第2组,静脉注射2%(75.0mg/kg)利多卡因。对照组未给予或使用利多卡因。插管后1分钟和4分钟,测量患者的血流动力学和生命体征。

所用统计分析方法

使用Stata 13软件通过重复测量方差分析进行数据分析。

结果

虽然第1组(雾化吸入利多卡因)的平均动脉血压(MAP)低于第2组(静脉注射利多卡因),但两组之间无显著差异。两组的MAP均与对照组有显著差异。至于平均脉搏数,雾化吸入和静脉注射利多卡因组之间观察到显著差异;因此,第1组(吸入)的平均脉搏数低于第2组(静脉注射)。

结论

由于血压在140/90以下被认为是正常的,且可能不会引发任何血流动力学并发症,因此可以得出结论,雾化吸入利多卡因比静脉注射利多卡因能更有效地控制插管引起的血流动力学变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043a/5872855/72f17c9ba5b8/AER-12-159-g002.jpg

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