摘要
目的评价达克罗宁胶浆含服复合丁卡因喷雾对冠心病患者气管插管期应激反应的影响。方法选择2018年10月至2019年9月在我院收治的行非心脏手术的冠心病患者80例,按照随机数字表法分成四组:单纯全麻组(A组)、全麻联合达克罗宁组(B组)、全麻联合丁卡因组(C组),全麻联合达克罗宁复合丁卡因组(D组),每组各20例。观察并记录麻醉诱导前(T_(0))、诱导后(T_(1))、C组和D组第一次喉镜置入后(T_(2))、气管插管后(T_(3))的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)变化,计算二重指数(RPP)。检测T_(0)和T_(3)血浆肾上腺素(E)和去甲肾上腺素(NE)水平。结果四组患者T_(1)的SBP、DBP、MAP、HR和RPP均较T_(0)降低(P<0.05)。T_(2)时间点D组患者SBP、DBP、MAP、HR和RPP低于C组(P<0.05)。T_(3)时间点C组、D组患者SBP、DBP、MAP、HR和RPP低于A组B组(P<0.05)。T_(3)时间点A组和B组患者的E和NE较T_(0)升高(P<0.05),C组D组患者的E和NE低于A组B组(P<0.05)。结论达克罗宁胶浆含服复合丁卡因喷雾表面麻醉用于冠心病患者非心脏手术气管插管,可有效降低围插管期的血压、心率及二重指数,保持血流动力学平稳,不加重心肌负担,患者接受度良好。
Objective To evaluate the effect of the oral administration of dyclonine mucilage combined with tetracaine spray on stress response during endotracheal intubation in patients with coronary heart disease(CHD).Methods A total of 80 patients with CHD undergoing non-cardiac surgery admitted to our hospital from October 2018 to September 2019 were selected,and they were divided into four groups according to the random number table:The simple general anesthesia group(group A),the general anesthesia combined with dyclonine group(group B),the general anesthesia combined with tetracaine group(group C),and the general anesthesia combined with dyclonine plus tetracaine group(group D),with 20 cases every group.The systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)and heart rate(HR)were observed and recorded before the induction of anesthesia(T_(0)),after induction(T_(1)),after the first laryngoscope placement(T_(2))of group C and group D and after tracheal intubation(T_(3)).The rate pressure product(RPP)was calculated.The plasma adrenaline(E)and norepinephrine(NE)levels were detected at T_(0) and T_(3).Results The levels of SBP,DBP,MAP,HR and RPP at T_(1) in the four groups were all lower than those at T_(0)(P<0.05).At T_(2),the levels of SBP,DBP,MAP,HR and RPP of group D were lower than those of group C(P<0.05).At T_(3),the levels of SBP,DBP,MAP,HR and RPP of group C and group D were lower than those of group A and group B(P<0.05).Levels of E and NE at T_(3)in group A and group B were higher than those at T_(0)(P<0.05).Levels of E and NE in group C and group D were lower than those in group A and group B(P<0.05).Conclusion The oral administration of dyclonine mucilage with topical anesthesia of tetracaine spray can effectively reduce blood pressure,HR and RPP during periintubation,maintain stable hemodynamics,does not increase the burden of myocardium in non-cardiac surgery tracheal intubation in patients with CHD,with a good acceptance of patients.
作者
金鑫
高守琳
柳阳
唐涛
JIN Xin;GAO Shoulin;LIU Yang;TANG Tao(Department of Anesthesiology,Dalian Friendship Hospital,Dalian 116001,China)
出处
《中国现代医生》
2021年第33期141-145,共5页
China Modern Doctor
关键词
达克罗宁
丁卡因
表面麻醉
冠心病
Dyclonine
Tetracaine
Topical anesthesia
Coronary heart disease
