Bunting H E, Kelly M C, Milligan K R
Queen's University of Belfast, Department of Anaesthetics, Ireland.
Br J Anaesth. 1995 Nov;75(5):631-3. doi: 10.1093/bja/75.5.631.
This study was designed to assess the effect of nebulized lignocaine or saline given before induction on the quality of induction of anaesthesia with desflurane in unpremedicated, young, adult males. Of the first six patients, five developed laryngospasm, breath-holding, coughing and increased secretions. In four patients oxygen saturation decreased to 92% or less. Significant tachycardia and hypertension occurred in four patients, and bradyarrhythmia after induction occurred in three patients. Hiccups and bronchospasm occurred in one patient. Because of the unacceptably high incidence of complications, the study was discontinued. The incidence and severity of complications were not decreased by administration of nebulized lignocaine and were higher than those reported by other workers. We conclude that in unpremedicated, young, adult males, induction of anaesthesia with desflurane and nitrous oxide in oxygen was associated with a high incidence of respiratory irritant effects, tachycardia, hypertension and post-induction bradyarrhythmia. We also found that lignocaine, as used in this study, did not appear to obtund the cardiovascular and respiratory complications during inhalation induction using desflurane.
本研究旨在评估在未使用术前药的年轻成年男性中，诱导麻醉前雾化吸入利多卡因或生理盐水对地氟醚麻醉诱导质量的影响。在前6例患者中，5例出现喉痉挛、屏气、咳嗽及分泌物增多。4例患者的血氧饱和度降至92%或更低。4例患者出现显著的心动过速和高血压，3例患者诱导后出现缓慢性心律失常。1例患者出现呃逆和支气管痉挛。由于并发症发生率高得令人难以接受，该研究停止。雾化吸入利多卡因并未降低并发症的发生率和严重程度，且高于其他研究者报告的发生率。我们得出结论，在未使用术前药的年轻成年男性中，使用地氟醚和氧化亚氮在氧气中诱导麻醉会导致较高的呼吸道刺激效应、心动过速、高血压及诱导后缓慢性心律失常发生率。我们还发现，本研究中使用的利多卡因似乎并未减轻使用地氟醚进行吸入诱导时的心血管和呼吸系统并发症。
