标题：七氟烷联合利多卡因在麻醉诱导插管中的应用

      作者：景莹莹，孙家潭，崔凯    (中国人民解放军第254医院麻醉科，天津 300142)

      卷次： 2018年29卷23期

      【摘要】 目的 探讨七氟烷联合利多卡因在麻醉诱导插管中的应用效果。方法 选择2015年10月至2017年10月中国人民解放军第254医院接诊拟行下腹部手术的90例患者，通过随机数表法将患者分为观察组和对照组，每组45例，对照组给予七氟烷吸入进行麻醉诱导，观察组在对照组的基础上联合利多卡因进行麻醉诱导。比较两组患者诱导前、插管即刻、插管后1 min、5 min的平均动脉压(MAP)、心率(HR)、外周血管阻力(SVR)、每博输出量(SV)、每分输出量(CO)、峰值速度(VpK)和静射血时间百分比(ET)的变化及术后拔管期躁动、呛咳发生率。结果 与诱导前比较，两组患者插管即刻、插管后 1 min、5 min时的MAP、HR均有所降低，且观察组患者插管即刻、插管后1 min、5 min时的MAP、HR均明显高于对照组，差异均有统计学意义(P<0.05)；与诱导前比较，两组患者插管即刻、插管后 1 min、5 min时的 SVR、SV、CO、VpK均有一定程度降低，ET明显升高，且观察组患者插管即刻、插管后1 min、5 min时的SVR、SV、CO、VpK明显高于对照组，ET明显低于对照组，差异均有统计学意义(P<0.05)；观察组患者术后拔管期躁动、呛咳发生率分别为4.44%和15.56%，均明显低于对照组的22.22%和37.50%，差异均有统计学意义(P<0.05)。结论 七氟烷联合利多卡因用于麻醉诱导插管中效果显著，其对血流动力学、心功能影响均较少，且可降低拔管期躁动、呛咳发生率，安全性高。
      【关键词】 麻醉诱导；气管插管；七氟烷；利多卡因；应用效果
      【中图分类号】 R614 【文献标识码】 A 【文章编号】 1003—6350（2018）23—3332—04

Application of sevenfluorane combined with lidocaine in anesthesia induction intubation.
JING Ying-ying, SUNJia-tan, CUI Kai. Department of Anesthesiology, the 254th Hospital of Chinese People's Liberation Army, Tianjin 300142,CHINA
【Abstract】 Objective To study the application effect of sevoflurane combined with lidocaine in anesthesia in-duction intubation. Methods A total of 90 patients who underwent lower abdomen operation in the 254th Hospital ofChinese People's Liberation Army from October 2015 to October 2017 were selected as research subjects. According tothe random number table, the patients were divided into an observation group and a control group, with 45 cases in eachgroup. The control group was given anesthetic induction with sevoflurane inhalation, and the observation group was com-bined with lidocaine for anesthesia induction on the basis of the control group. The changes of mean arterial pressure(MAP), heart rate (HR), peripheral vascular resistance (SVR), stroke volume (SV), cardiac output (CO), peak velocity(VpK) and percentage of ejection time (ET) at static period were compared between the two groups before induction,immediately after intubation, at 1 min and 5 min after intubation. The incidence of postoperative agitation and coughduring extubation was also compared between the two groups. Results Compared with before induction, the MAPand HR of the two groups were all reduced at the time of immediately after intubation, and at 1 min and 5 min after in-tubation; the MAP and HR of the observation group were all higher than those of the control group immediately afterintubation, and at 1 min and 5 min after intubation; the differences were statistically significant (P<0.05). Comparedwith before induction, the SVR, SV, CO and VpK of the two groups were all reduced at the time of immediately afterintubation, at 1 min and 5 min after intubation, and the ET increased significantly; the SVR, SV, CO and VpK of theobservation group were significantly higher than those of the control group immediately after intubation, at 1 min and5 min after intubation, and the ET was significantly lower than that of the control group; all differences were statistical-ly significant (P<0.05). The incidence of postoperative agitation and cough during extubation in the observation groupwere 4.44% and 15.56% , respectively, which were significantly lower than those of the control group (22.22% and37.50% , respectively); both differences were statistically significant (P<0.05). Conclusion Sevoflurane combinedwith lidocaine is effective in anesthesia induction intubation, which has less influence on hemodynamics and cardiacfunction, and can reduce the incidence of agitation and cough during extubation, with high safety. It is worthy of clini-cal application.
      【Key words】 Anesthesia induction; Tracheal intubation; Sevoflurane; Lidocaine; Application effect·论 著·doi:10.3969/j.issn.1003-6350.2018.23.024