气管导管套囊内注射碱性利多卡因与空气对儿童拔管期间血流动力学反应和术后气道并发症的影响：埃塞俄比亚前瞻性观察性队列研究。
Effect of tracheal tube cuff inflation with alkalinized lidocaine versus air on hemodynamic responses during extubation and post-operative airway morbidities in children: prospective observational cohort study, Ethiopia.
机构信息
Department of Anesthesia, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
University Hospital, Hiwot Fana Specialized University Hospital, Harar, Ethiopia.
出版信息
BMC Anesthesiol. 2022 Nov 4;22(1):337. doi: 10.1186/s12871-022-01868-2.
BACKGROUND
Endotracheal tube with an inflated cuff was used to manage and maintain the airway during general anesthesia in children. When the lateral pressure exerted by an inflated Endotracheal tube cuff on tracheal mucosa exceeds capillary perfusion pressure, patients may complain of cough, sore throat, and hoarseness in the postoperative period. This study aimed to assess the effect of a tracheal tube cuff filled with alkalinized lidocaine versus air on hemodynamic parameter changes during extubation and post-operative airway morbidity in children.
METHODS
Institutional based observational prospective cohort study was conducted among 56 elective children; aged 3-13 years, who underwent operation under general anesthesia with cuffed endotracheal intubation for greater than one hour by grouping into the air (group1) and alkalinized Lidocaine (group2) at Tikur Anbessa specialized Hospital. Hemodynamic parameters (Heart rate and Blood pressure) and other variables were measured starting from 5 min before extubation to 24th hours after extubation of the endotracheal tube. A Comparison of numerical variables between study group was done with an independent t-test. Data were expressed in terms of mean ± standard deviation. Categorical data were assessed by Chi-square tests.
RESULTS
Postoperative Sore throat was lower in alkalinized lidocaine group compared to the air group. The mean heart rate at five minutes after extubation was significantly lower in alkalinized lidocaine group (107.29 ± 6.457 beat per minute (bpm)) compared to the air group (122.04 ± 8.809 bpm), with P ≤ 0.001. Systolic blood pressure was also significantly lower in alkalinized lidocaine group (99.64 ± 8.434 millimeters of mercury (mmHg)) compared to the air group (108.21 ± 11.902 mmHg), p = 0.016 at five minutes after extubation.
CONCLUSION
Alkalinized lidocaine inflated tracheal tubes have shown improved hemodynamic and laryngotracheal morbidities in children.
背景
在儿童全身麻醉期间，使用带充气套囊的气管内管来管理和维持气道。当充气的气管内管套囊对气管黏膜施加的侧向压力超过毛细血管灌注压时，患者可能会在术后出现咳嗽、咽痛和声音嘶哑。本研究旨在评估在儿童中，用碱性利多卡因充盈的气管内管套囊与空气充盈相比，对拔管期间血流动力学参数变化和术后气道发病率的影响。
方法
在提克里特安贝萨专科医院，对 56 名接受全身麻醉并使用带套囊的气管内插管进行超过 1 小时手术的择期儿童（年龄 3-13 岁）进行了基于机构的前瞻性队列研究。通过将患者分为空气组（第 1 组）和碱性利多卡因组（第 2 组），来对血流动力学参数（心率和血压）和其他变量进行测量，从气管内插管拔管前 5 分钟开始，一直测量到拔管后 24 小时。使用独立 t 检验比较研究组之间的数值变量。数据以均值±标准差表示。使用卡方检验评估分类数据。
结果
与空气组相比，碱性利多卡因组术后咽痛发生率较低。与空气组（122.04±8.809 次/分）相比，碱性利多卡因组拔管后 5 分钟时的平均心率显著较低（107.29±6.457 次/分），p≤0.001。碱性利多卡因组的收缩压也明显低于空气组（拔管后 5 分钟时为 99.64±8.434 毫米汞柱[mmHg]），p=0.016。
结论
碱性利多卡因充气气管内管在儿童中显示出改善的血流动力学和喉气管发病率。
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