中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2010年
5期
579-581
,共3页
康亚梅%郑书芬%徐云%俞卫锋
康亞梅%鄭書芬%徐雲%俞衛鋒
강아매%정서분%서운%유위봉
利多卡因%投药,吸入%麻醉,气管内%支气管镜检查%插管法,气管内%脊髓损伤%截瘫
利多卡因%投藥,吸入%痳醉,氣管內%支氣管鏡檢查%插管法,氣管內%脊髓損傷%截癱
리다잡인%투약,흡입%마취,기관내%지기관경검사%삽관법,기관내%척수손상%절탄
Lidocaine%Administration,inhalation%Anesthesia,intratracheal%Bronchoscopy%Intubafion,intratracheal%Trauma,nervous system%Paraplegia
目的 评价雾化吸入利多卡因用于颈髓损伤高位截瘫患者纤维支气管镜(FOB)引导气管插管时表面麻醉的效果.方法 颈椎骨折并发高位截瘫患者64例,随机分为2组(n=32),雾化吸入组:雾化吸入2%利多卡因;喷雾联合环甲膜穿刺组:咽喉部喷雾联合环甲膜穿刺注射2%利多卡因,随后于FOB引导气管插管前15 min,两组均静脉注射咪达唑仑0.01 mg/kg、芬太尼1 μg/kg.FOB引导气管插管期间,评价气管插管条件,监测MAP、HR、ECG及SpO2.结果 与喷雾联合环甲膜穿刺组相比,雾化吸入组气管插管条件满意率和FOB引导气管插管成功率明显提高,心律失常及不良记忆发生率明显降低(P＜0.05).结论 颈髓损伤高位截瘫患者雾化吸入2%利多卡因表面麻醉,有助于改善FOB引导气管插管的条件,且降低不良反应的发生.
目的 評價霧化吸入利多卡因用于頸髓損傷高位截癱患者纖維支氣管鏡(FOB)引導氣管插管時錶麵痳醉的效果.方法 頸椎骨摺併髮高位截癱患者64例,隨機分為2組(n=32),霧化吸入組:霧化吸入2%利多卡因;噴霧聯閤環甲膜穿刺組:嚥喉部噴霧聯閤環甲膜穿刺註射2%利多卡因,隨後于FOB引導氣管插管前15 min,兩組均靜脈註射咪達唑崙0.01 mg/kg、芬太尼1 μg/kg.FOB引導氣管插管期間,評價氣管插管條件,鑑測MAP、HR、ECG及SpO2.結果 與噴霧聯閤環甲膜穿刺組相比,霧化吸入組氣管插管條件滿意率和FOB引導氣管插管成功率明顯提高,心律失常及不良記憶髮生率明顯降低(P＜0.05).結論 頸髓損傷高位截癱患者霧化吸入2%利多卡因錶麵痳醉,有助于改善FOB引導氣管插管的條件,且降低不良反應的髮生.
목적 평개무화흡입리다잡인용우경수손상고위절탄환자섬유지기관경(FOB)인도기관삽관시표면마취적효과.방법 경추골절병발고위절탄환자64례,수궤분위2조(n=32),무화흡입조:무화흡입2%리다잡인;분무연합배갑막천자조:인후부분무연합배갑막천자주사2%리다잡인,수후우FOB인도기관삽관전15 min,량조균정맥주사미체서륜0.01 mg/kg、분태니1 μg/kg.FOB인도기관삽관기간,평개기관삽관조건,감측MAP、HR、ECG급SpO2.결과 여분무연합배갑막천자조상비,무화흡입조기관삽관조건만의솔화FOB인도기관삽관성공솔명현제고,심률실상급불량기억발생솔명현강저(P＜0.05).결론 경수손상고위절탄환자무화흡입2%리다잡인표면마취,유조우개선FOB인도기관삽관적조건,차강저불량반응적발생.
Objective To evaluate the efficacy of topical anesthesia with inhaled aerosolized lidocaine during tracheal intubation under the guidance of fiberoptic bronchoscopy (FOB) in patients with cervical cord injury complicated with high paraplegia. Methods Sixty-four patients with cervical cord injury complicated with high paraplegia were randomly divided into 2 groups ( n = 32 each): group Ⅰ aerosol inhalation and group Ⅱ spray and cricothyroid membrane puncture. In group Ⅰ aerosolized 2% lidocaine was inhaled. In group Ⅱ after the pharynx and larynx was sprayed with 2% lidocaine, cricothyroid membrane puncture was performed and then 2% lidocaine 2 ml was injected. Midazolam 0.01 mg/kg and fentanyl 1 μg/kg were injected iv in both groups 15 min before tracheal intubation guided by FOB. During tracheal intubation guided by FOB, the intubation condition was assessed, and MAP, HR, ECG and SpO2 were monitored. Results The satisfactory rate of intubation condition and success rate of intubation under the guidance of FOB were significantly higher, and the incidences of arrhythmia and bad memory lower in group Ⅰ than in group Ⅱ ( P ＜ 0.05). Conclusion The topical anesthesia with inhaled aerosolized 2% lidocaine is helpful for improving the FOB-guided tracheal intubation condition, and can reduce the occurrence of adverse effects in patients with cervical cord injury complicated with high paraplegia.
