Gaziosmanpaşa Taksim Education and Research Hospital Otolaryngology Department, İstanbul, Turkey.
Gaziosmanpaşa Taksim Education and Research Hospital Otolaryngology Department, İstanbul, Turkey.
J Voice. 2020 Jan;34(1):130-133. doi: 10.1016/j.jvoice.2018.08.012. Epub 2018 Sep 15.
To examine the systemic and local effects of the lidocaine on the larynx and trachea which is applied after the end of the surgery and through various application methods.
Randomized controlled prospective study.
The study is composed of patients who underwent suspension laryngoscopy (SL) for benign laryngeal diseases (cysts, polyp, granuloma, etc) and American Society of Anesthesiologists (ASA) I, between January 2017 and January 2018. The patients were randomly divided into 3 groups. In the first group nothing is applied at the end of the surgery and called as control group, second group received 7 pufs of aerosolized 10% lidocaine solution (70 mg) over larynx and trachea and third group received cotton swaps that impregnated in 1 ml of 20 mg lidocaine solution over surgical area for 1 minutes. Operation and arousal times, heart rate and mean arterial blood pressure levels were noted and compared. Also laryngospasm, cough, and agitation scores were obtained during arousal.
64 patients were included in the study. Laryngospasm was not observed in any of the patients. In group 2 (aerosolized lidocaine group), patients' blood pressure remained similar while increased in other groups (P < 0.05). Agitation scores were significantly lower in group 2 compared to the other groups (P = 0.012). Cough reflex is observed less in group 2 but result was not statistically significant (P = 0.13) CONCLUSION: The usage of aerosolized lidocaine after suspension laryngoscopy is very effective in blocking the stimulation of superior laryngeal nerve and sympathetic nerves which were responsible for the pressor reflexes. The inhibition of these reflexes before or during arousal could secure a safer arousal.
观察术毕经不同途径应用利多卡因对喉及气管的全身及局部影响。
随机对照前瞻性研究。
本研究纳入 2017 年 1 月至 2018 年 1 月期间因良性喉部疾病（囊肿、息肉、肉芽肿等）行悬雍垂喉镜（SL）检查且美国麻醉医师协会（ASA）分级为 I 级的患者。患者随机分为 3 组，第 1 组术毕不做任何处理（对照组），第 2 组在喉及气管给予 7 喷 10%利多卡因气雾剂（70mg），第 3 组在手术区域用浸有 1ml 20mg 利多卡因溶液的棉签擦拭 1 分钟。记录并比较手术及苏醒时间、心率和平均动脉压水平，同时在苏醒时评估喉痉挛、咳嗽和躁动评分。
共纳入 64 例患者，所有患者均未发生喉痉挛。在第 2 组（雾化利多卡因组），患者的血压保持不变，而其他组的血压则升高（P<0.05）。与其他两组相比，第 2 组患者的躁动评分显著降低（P=0.012）。第 2 组咳嗽反射较少，但结果无统计学意义（P=0.13）。
术毕行 SL 时应用雾化利多卡因可有效阻断喉上神经和交感神经的刺激，抑制其在苏醒前或苏醒时引起的升压反射，可确保更安全的苏醒。
