Koç C, Kocaman F, Aygenç E, Ozdem C, Cekiç A
Second Otolaryngology--Head and Neck Surgery Clinic, Ankara Numune Hospital, Turkey.
Otolaryngol Head Neck Surg. 1998 Jun;118(6):880-2. doi: 10.1016/S0194-5998(98)70290-6.
The most important complications from tonsillectomy and adenoidectomy are bleeding, stridor, and laryngospasm. This controlled, double-blind study was designed to investigate the effects of topical and intravenous lidocaine on stridor and laryngospasm. A total of 134 patients scheduled for elective tonsillectomy and/or adenoidectomy were randomly separated into four groups. In the topical lidocaine group 4 mg/kg of 2% lidocaine was applied to subglottic, glottic, and supraglottic areas before endotracheal intubation. Normal saline solution was used topically for the first control group. In the intravenous lidocaine group, patients were given 1 mg/kg of 2% lidocaine before extubation, and the same amount of 0.9% NaCl was given to the second control group. Postoperative stridor, laryngospasm, cyanosis, bleeding, sedation degree, and respiratory depression were observed, and plasma lidocaine levels were measured. Both topical and intravenous lidocaine groups revealed less stridor and laryngospasm than the control groups, and no difference was found between the topical and intravenous lidocaine groups except the higher sedation scores in the early postoperative period for the intravenous lidocaine group.
扁桃体切除术和腺样体切除术最重要的并发症是出血、喘鸣和喉痉挛。这项对照双盲研究旨在调查局部和静脉注射利多卡因对喘鸣和喉痉挛的影响。共有134例计划进行择期扁桃体切除术和/或腺样体切除术的患者被随机分为四组。在局部利多卡因组中，在气管插管前将4mg/kg的2%利多卡因应用于声门下、声门和声门上区域。第一对照组局部使用生理盐水。在静脉注射利多卡因组中，患者在拔管前给予1mg/kg的2%利多卡因，第二对照组给予等量的0.9%氯化钠。观察术后喘鸣、喉痉挛、发绀、出血、镇静程度和呼吸抑制情况，并测量血浆利多卡因水平。局部和静脉注射利多卡因组的喘鸣和喉痉挛均少于对照组，除静脉注射利多卡因组术后早期镇静评分较高外，局部和静脉注射利多卡因组之间未发现差异。
