丁卡因胶浆对全身麻醉拔管期血流动力学的影响

目的 研究丁卡因胶浆对全身麻醉拔管期血流动力学的影响.方法 将100例择期气管插管全身麻醉患者按随机数字表法分为对照组和试验组,每组50例.对照组在气管导管表面均匀涂抹无菌液态石蜡油,试验组于相同部位均匀涂抹丁卡因胶浆.记录麻醉诱导前（T1）、手术结束停止输注药物后5 min（T2）、拔管后1 min（T3）、拔管后3 min（T4）、拔管后5 min （T5）的收缩压、舒张压和心率,患者术后清醒时耐管效果,术后24h发生咽喉痛、声音嘶哑的例数.结果 两组T1、T2收缩压、舒张压、心率比较差异均无统计学意义（P＞0.05）;试验组T3 ～T5收缩压、舒张压、心率明显低于对照组收缩压：（122.3±11.3）,（120.0±9.8）,（112.0±6.3） mmHg（1 mmHg =0.133 kPa）比（158.3±15.0）,（142.5±13.5）,（133.0±14.5） mmHg;舒张压：（75.0±13.5）,（75.8±10.5）,（58.3±4.2） mmHg比（111.0±20.3）,（106.5±12.8）,（63.8±15.8） mmHg;心率：（81.9±13.7）,（83.6±13.4）,（60.7±3.5）次/min比（113.5±19.4）,（117.5±21.7）,（71.8±14.6）次/min],差异均有统计学意义（P＜0.05）.试验组耐管总有效率明显高于对照组96％（48/50）比56％（28/50）],咽喉痛和声音嘶哑发生率明显低于对照组6％（3/50）比48％（24/50）和4％（2/50）比36％（18/50）],差异均有统计学意义（P＜0.05）.结论 丁卡因胶浆可以减轻全身麻醉患者拔管期血流动力学的剧烈波动,能增强患者对气管导管的耐受性,有效降低全身麻醉气管插管所引起的咽喉痛和声音嘶哑的发生率.

The effect of tetracaine jelly on hemodynamics during extubation period in general anesthesia

Objective To study the effect of tetracaine jelly on hemodynamics during extubation period in general anesthesia. Methods One hundred patients who performed tracheal cannula and general anesthesia were divided into control group （50 patients） and experiment group （50 patients） by random digits table method. Control group： sterile paraffin oil was applied to the endotracheal tube. Experiment group： tetracaine jelly was applied to the endotracheal tube. The systolic blood pressure （SBP）,diastolic blood pressure （DBP） and heart rate （HR） were measured before the anesthesia induction （T1）, 5 min after stopping infusion drugs （T2）, 1 rain after tracheal extubation （T3）, 3 min after tracheal extubation （T4） and 5 min after tracheal extubation （T5） were observed. The resistant effect after waking and the number of sore throat, hoarseness were recorded. Results The level of SBP, DBP, HR at T1 and T2 had no significant difference between two groups （P 〉 0.05 ）. The level of SBP, DBP, HR at T3 - T5 in experiment group were significantly lower than those in control group SBP： （ 122.3 ± 11.3 ）, （ 120.0 ± 9.8）, （ 112.0 ± 6.3 ） mmHg （ 1 mmHg = 0.133 kPa） vs. （ 158.3 ± 15.0）, （ 142.5 ± 13.5）, （ 133.0 ± 14.5） mmHg;DBP： （75.0 ± 13.5）, （75.8 ± 10.5 ）, （58.3 ± 4.2） mmHg vs.（ 111.0 ± 20.3 ）, （ 106.5 ± 12.8）, （63.8 ± 15.8） mmHg;HR： （81.9 ± 13.7）, （83.6 ± 13.4）, （60.7 ± 3.5） times/min vs.（ 113.5 ± 19.4）, （ 117.5 ± 21.7）, （71.8 ± 14.6） times/mini （P 〈 0.05）. The total effective rate of tolerance in experiment group was higher than that in control group 96%（48/50） vs. 56%（ 28/50 ）], the rate of sore throat and hoarseness were lower than those in control group 6% （3/50） vs. 48% （24/50）, 4% （2/50） vs. 36% （18/50） ], there were significant differences （P 〈 0.05 ）. Conclusion Tetracaine jelly can reduce the cardiovascular response of tracheal extubation, enhance the tolerance of tracheal tube and decrease the morbidity of sore throat and hoarseness.