摘要
目的 评价注药型气管导管持续气道表面麻醉抑制颌面部手术患者术后留置气管导管反应的效果.方法 择期全麻下行颌面部手术患者60 例,性别不限,年龄18~64 岁,体重45~75 kg,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组( n=30):对照组( C组)和注药型气管导管持续气道表面麻醉组(E组).术毕留置气管导管至ICU,静脉注射咪达唑仑0.02~0.03 mg∕kg,静脉输注舒芬太尼0. 02~0. 10 μg·kg-1·h-1镇静,E组每隔2 h经注药型气管导管注入2%利多卡因2 ml行气道表面麻醉,C组每隔2 h经注药型气管导管注入等容量生理盐水,维持患者Ramsay镇静评分≥2分.记录入ICU后24 h内高血压、心动过速和呛咳的发生情况和镇静药物用量;于入ICU后24 h时采用酶联免疫吸附法测定尿去甲肾上腺素和甲氧肾上腺素的浓度.结果 与C组比较,E组高血压、心动过速和呛咳的发生次数降低,咪达唑仑和舒芬太尼的用量减少,尿去甲肾上腺素和甲氧肾上腺素的浓度降低(P<0. 05).结论 注药型气管导管持续气道表面麻醉可明显抑制颌面部手术患者术后留置气管导管反应.
Objective To evaluate the efficacy of endotracheal tube (ETT) with injecting medicine for continuous airway topical anesthesia in inhibiting responses to an indwelling ETT after operation in the patients undergoing maxillofacial surgery. Methods Sixty patients of both sexes, aged 18-64 yr, weig-hing 45-75 kg, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, scheduled for elective maxillofacial surgery under general anesthesia, were divided to control group ( group C) and ETT with in-jecting medicine for continuous airway topical anesthesia group (group E) by a random number table meth-od, with 30 patents in each group. ETT was indwelled until the patients were admitted to intensive care unit (ICU) after the end of surgery, midazolam 0. 02-0. 03 mg∕kg was intravenously injected, and sufentanil was intravenously infused at a rate of 0. 02-0. 10 μg·kg-1·h-1for sedation. In group E, 2% lidocaine 2 ml was injected through the ETT with injecting medicine every 2 h to perform airway topical anesthesia. The equal volume of normal saline was injected through the ETT with injecting medicine every 2 h to maintain the Ramsay sedation score ≥2 in group C. The occurrence of hypertension, tachycardia and bucking and seda-tive requirements were recorded within 24 h after admission to ICU. The concentrations of norepinephrine and methoxyepinephrine in urine were determined by enzyme-linked immunosorbent assay at 24 h after ad- mission to ICU. Results Compared with group C, the frequency of hypertension, tachycardia and bucking were significantly decreased, the consumption of midazolam and sufentanil was reduced, and the concentra-tions of norepinephrine and methoxyepinephrine in urine were decreased in group E (P<0. 05). Conclusion ETT with injecting medicine can markedly inhibit responses to an indwelling ETT after operation when used for continuous airway topical anesthesia in the patients undergoing maxillofacial surgery.
作者
胡振华
代彦文
贾彬彬
刘胜群
Hu Zhenhua;Dai Yanwen;Jia Binbin;Uu Shengqun(Department of Anesthesiology,Henan Province People's Hospital,Zhengzhou 450003,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2018年第7期859-862,共4页
Chinese Journal of Anesthesiology
基金
河南省医学科技攻关项目(201303140)。
关键词
导管
留置
麻醉
局部
应激
Catheters,indwelling
Anesthesia,local
Stress
