收稿日期: 2021-04-26
网络出版日期: 2022-01-28
Clinical comparison on patients undergoing general anesthesia and tracheal intubation between Jinhoujian and lidocaine aerosol
Received date: 2021-04-26
Online published: 2022-01-28
目的·比较金喉健喷雾剂和利多卡因气雾剂在全身麻醉气管插管中的临床应用效果。方法·纳入上海交通大学医学院附属瑞金医院100例择期行腹腔镜胆囊切除术的全身麻醉气管插管的患者，按随机数字表分为金喉健喷雾剂组（研究组）和利多卡因气雾剂组（对照组），每组50例。麻醉诱导后l min，在UE可视喉镜暴露声门后，将金喉健喷雾剂或利多卡因气雾剂于咽喉部分别按2揿。观察插管前（T0）、插管即刻（T1）、插管后3 min（T2）、插管后5 min（T3）、插管后10 min（T4）、拔管即刻（T5）、拔管后3 min（T6）和拔管后5 min（T7）的平均动脉压（mean arterial pressure， MAP）和心率（heart rate， HR）变化。记录患者拔管前后苏醒期躁动评分和对气管导管的耐受度。术后24 h进行随访，观察患者咽喉疼痛、声音嘶哑及拔管反应等情况。结果·2组患者一般情况具有可比性。2组患者经药物处理后，都能预防气管插管和拔管引起的心血管应激反应，MAP、HR、苏醒期躁动评分比较，差异均无统计学意义。与对照组相比，研究组对气管导管的耐受满意度（P=0.021）和可接受度（P=0.021）明显提高，且术后24 h内咽痛发生率显著减低（P=0.020）。结论·应用金喉健喷雾剂能有效降低全身麻醉气管插管引起的心血管应激反应，提高行腹腔镜胆囊切除术患者对气管导管的耐受度，减轻术后咽痛发生率。
吴雷 , 杜重临 , 夏一梦 . 金喉健喷雾剂和利多卡因气雾剂在全身麻醉气管插管中的应用比较[J]. 上海交通大学学报（医学版）, 2022 , 42(1) : 90 -94 . DOI: 10.3969/j.issn.1674-8115.2022.01.013
·To compare the clinical application of Jinhoujian spray and Lishuka aerosol (lidocaine) in tracheal intubation under general anesthesia.
·A total of 100 patients undergoing elective laparoscopic cholecystectomy with tracheal intubation under general anesthesia were enrolled in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. They were randomly divided into Jinhoujian spray group (research group) and lidocaine aerosol group (control group), with 50 patients each. 1 min after anesthesia induction, the glottis was exposed by UE visual laryngoscope and Jinhoujian spray or lidocaine aerosol was applied to the throat by 2 press respectively. Mean arterial pressure (MAP) and heart rate (HR) were recorded at different time points, including before anesthesia induction (T0) , the time (T1),3 min (T2), 5 min (T3) and 10 min (T4) after intubation of endotracheal tube, the time (T5), 3 min (T6) and 5 min (T7) after extubation of endotracheal tube. MAP and HR were observed at different time points, including before (T0) and immediately after intubation (T1), 3 min (T2), 5 min (T3) and 10 min after intubation (T4), immediately (T5), 3 min (T6) and 5 min after extubation (T7). The emergence agitation and acceptance of tracheal tube were also recorded before and after extubation. The patients were followed up 24 h after the operation to observe pharyngalgia, hoarseness and extubation responses.
·There was no significant difference in general features between the two groups. After drug treatment, both groups could prevent the cardiovascular stress response caused by endotracheal intubation and extubation. And there was no statistical significance in MAP, HR and emergence agitation scores. Compared with the control group, the tolerance satisfaction of tracheal catheter (P=0.021) and acceptability (P=0.021) were significantly improved in the research group, and the incidence of pharyngeal pain within 24 h after surgery was significantly reduced (P=0.020).
·The application of Jinhoujian spray can effectively reduce the cardiovascular stress response caused by tracheal intubation under general anesthesia, improve the tolerance of patients undergoing laparoscopic cholecystectomy to tracheal catheter, and reduce the incidence of postoperative pharyngeal pain.
Key words： Jinhoujian aerosol; lidocaine; tracheal intubation; haemodynamics; pharyngalgia
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