CAJ | 학술논문

目的探讨利多卡因辅助瑞芬太尼用于喉显微术无肌松诱导气管插管的疗效. 方法 75例喉显微术患者,采用随机数字表法将患者随机分为Ⅰ组(常规诱导)、Ⅱ组(瑞芬太尼)、Ⅲ组(利多卡因复合瑞芬太尼),每组25例.观察VibyMogenson评分、拔管时间和苏醒质量[运动活动评分(motor activity assessment scale,MAAS)],记录T1(诱导前)、T2(插管前即刻)、T3(插管后即刻)平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)和T1、T4(拔管后即刻)血糖(blood glucose,Glu)、皮质醇(cortisol,Cor)浓度. 结果 3组Viby-Mogenson各项评分差异无统计学意义(P＞0.05).Ⅱ组T2时MAP、HR为(64±7) mm Hg(1 mm Hg=0.133 kPa)、(61±6)次/min,明显低于Ⅰ组[(73±8) mm Hg、(68±8)次/min]、Ⅲ组[(71±8) mm Hg、(67±7)次/min] (P＜0.05).Ⅲ组拔管时间和T4时MAAS评分分别为(6.4±2.4) min和(4.1±1.3),明显少于Ⅰ组[(15.6±3.7) min 和(6.6±2.7)]、Ⅱ组[(7.9±2.6) min和(5.5±2.3)](P＜0.05).Ⅲ组T4时Glu和Cor浓度分别为(5.7±1.4) mmol/L和(0.77±0.68) mmol/L,明显低于Ⅰ组[(7.7±-1.7)、(0.98±0.54) mmol/L]、Ⅱ组[(7.5±1.6)、(0.97±0.49) mmol/L](P＜0.05). 结论利多卡因辅助瑞芬太尼用于喉显微术无肌松诱导气管插管安全可靠,疗效好.
목적 탐토리다잡인보조서분태니용우후현미술무기송유도기관삽관적료효. 방법 75례후현미술환자,채용수궤수자표법장환자수궤분위Ⅰ조(상규유도)、Ⅱ조(서분태니)、Ⅲ조(리다잡인복합서분태니),매조25례.관찰VibyMogenson평분、발관시간화소성질량[운동활동평분(motor activity assessment scale,MAAS)],기록T1(유도전)、T2(삽관전즉각)、T3(삽관후즉각)평균동맥압(mean artery pressure,MAP)、심솔(heart rate,HR)화T1、T4(발관후즉각)혈당(blood glucose,Glu)、피질순(cortisol,Cor)농도. 결과 3조Viby-Mogenson각항평분차이무통계학의의(P＞0.05).Ⅱ조T2시MAP、HR위(64±7) mm Hg(1 mm Hg=0.133 kPa)、(61±6)차/min,명현저우Ⅰ조[(73±8) mm Hg、(68±8)차/min]、Ⅲ조[(71±8) mm Hg、(67±7)차/min] (P＜0.05).Ⅲ조발관시간화T4시MAAS평분분별위(6.4±2.4) min화(4.1±1.3),명현소우Ⅰ조[(15.6±3.7) min 화(6.6±2.7)]、Ⅱ조[(7.9±2.6) min화(5.5±2.3)](P＜0.05).Ⅲ조T4시Glu화Cor농도분별위(5.7±1.4) mmol/L화(0.77±0.68) mmol/L,명현저우Ⅰ조[(7.7±-1.7)、(0.98±0.54) mmol/L]、Ⅱ조[(7.5±1.6)、(0.97±0.49) mmol/L](P＜0.05). 결론 리다잡인보조서분태니용우후현미술무기송유도기관삽관안전가고,료효호.
Objective To investigate the clinical effects of intravenous injection of lidocaine combined with remifentanil on tracheal intubation without muscle relaxants by for laryngeal microscopic surgery.Methods 75 ASA Ⅰ-Ⅱ patients undergoing laryngeal microscopic surgery for tracheal intubation without muscle relaxants were randomly divided into Group Ⅰ (conventional induction),group Ⅱ (remifentanil)and group Ⅲ (lidocaine combined with remifentanil).These intubating conditions (VibyMogenson),extubation time and awakening quality (movement activity score of the MAAS) were recorded.Mean arterial pressure (MAP) and heart rate (HR) were also recorded T1(before induction) and T2(immediately before) and T3(after intubation).Blood glucose(Glu) and cortisol(Cor) were tested at T2 and T4(extubation).Results There was no significant difference in the scores of VibyMogenson(P＞0.05).MAP[(64±7) mm Hg](1 mm Hg=0.133 kPa) and HR[(61±6) bpm] in Group Ⅱ were significantly lower than those in Group Ⅰ [(73±8) mm Hg,(68±8) bpm],Ⅲ[(71±8) mm Hg,(67±7) bpm] at T2 (P＜0.05).Extubation time [(6.4±2.4) min]and MAAS score[(4.1±1.3)] at T4 in group Ⅲ were significantly shorter than those in group Ⅰ [(15.6±3.7) min and (6.6±2.7)],Ⅱ [(7.9±2.6) min and (5.5±2.3)] (P＜0.05).Glu [(5.7± 1.4) mmol/L] and Cor [(0.77±0.68) mmol/L] in group Ⅲ were significantly lower than those in group Ⅰ [(7.7±1.7),(0.98±0.54) mmol/L],Ⅱ [(7.5±1.6),(0.97±0.49) mmol/L] at T4(P＜0.05).Conclusions Tracheal intubation without muscle relaxants by intravenous injection of lidocaine combined with remifentanil for laryngeal microscopic surgery was safe and efficient.