Department of Anesthesiology, The 988th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Zhengzhou, Henan 450042, China.
Department of Anesthesiology, Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China.
Biomed Res Int. 2022 Jun 16;2022:6554993. doi: 10.1155/2022/6554993. eCollection 2022.
Pediatric patients are facing greater difficulties in radial catheterization for anatomic variation and smaller diameter. This study is to investigate the efficacy of phentolamine accompanied by lidocaine subcutaneously under ultrasound guidance on radial catheterization in pediatric patients.
66 pediatric patients were enrolled and randomly divided into saline group, phentolamine group, and phentolamine+lidocaine group. Baseline characteristics and surgical types were collected. Relevant solutions were subcutaneously injected, and catheterization was subsequently conducted under ultrasound guidance. Radial artery diameter and depth were measured, the success rate of catheterization and procedure time were calculated, and the complications were evaluated with ultrasonography.
No significant differences were observed in age, sex, weight, American Society of Anesthesiologists' classification, systolic blood pressure, diastolic blood pressure, heart rate, hemoglobin, and surgical types among three groups. Subcutaneously, the diameter in phentolamine and phentolamine+lidocaine groups increased significantly compared with the saline group. Moreover, the diameter also increased significantly after injection compared with that before injection both in the phentolamine and phentolamine+lidocaine groups. The first-attempt success rates were significantly higher while the procedure times of cannulation were shorter in the phentolamine and phentolamine+lidocaine groups than that in the saline group. Kaplan-Meier analysis showed that the overall procedure time was shorter in the phentolamine and phentolamine+lidocaine groups than the saline group. Overall complications and vasospasm incidence were lower in the phentolamine and phentolamine+lidocaine groups than the saline group.
Phentolamine accompanied by lidocaine subcutaneous injection under ultrasound guidance improved the first-attempt success rate and reduced the complication of radial artery catheterization in pediatric patients.
儿科患者由于解剖结构变异和血管直径较小，行桡动脉置管术存在更大的困难。本研究旨在探讨超声引导下皮下注射酚妥拉明联合利多卡因对儿科患者桡动脉置管的效果。
纳入 66 例儿科患者，随机分为生理盐水组、酚妥拉明组和酚妥拉明+利多卡因组。记录患者的一般特征和手术类型。在超声引导下，各组分别皮下注射相应溶液后进行置管操作，测量桡动脉直径和深度，计算置管成功率和操作时间，并通过超声评估并发症。
三组患者的年龄、性别、体重、美国麻醉医师协会（ASA）分级、收缩压、舒张压、心率、血红蛋白和手术类型差异均无统计学意义。与生理盐水组相比，酚妥拉明组和酚妥拉明+利多卡因组的皮下注射部位动脉直径明显增大。与注射前相比，酚妥拉明组和酚妥拉明+利多卡因组的动脉直径在注射后均显著增大。与生理盐水组相比，酚妥拉明组和酚妥拉明+利多卡因组的首次置管成功率更高，置管操作时间更短。Kaplan-Meier 分析显示，酚妥拉明组和酚妥拉明+利多卡因组的总操作时间均短于生理盐水组。酚妥拉明组和酚妥拉明+利多卡因组的总并发症和血管痉挛发生率均低于生理盐水组。
超声引导下皮下注射酚妥拉明联合利多卡因可提高儿科患者桡动脉置管的首次成功率，减少并发症。
