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利多卡因雾化吸入在老年患者全麻诱导中的应用
Application of lidocaine nebulised inhalation for general anesthesia in the elderly

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DOI:
作者:
季惠, 尤新民 , 程志军, 施美新
JI Hui,YOU Xinmin,CHEN Zhijun,SHI Meixin
作者单位:
上海交通大学医学院附属新华医院崇明分院麻醉科
Department of Anesthesiology, Xinhua Hospital(Chongming),Shanghai Jiaotong University School of Medicine,Shanghai 202150, China
关键词:
利多卡因；雾化吸入；老年；血流动力学
Lidocaine; Nebulised inhalation;Elderly;Hemodynamics
摘要:
目的 观察2%利多卡因超声雾化吸入对老年患者全麻诱导中血流动力学变化的影响。方法 60例ASAⅠ或Ⅱ级拟行中上腹部手术的老年患者（年龄﹥65岁）随机分为三组，A组为对照组，B组为利多卡因静脉组，C组为利多卡因超声雾化吸入组。观察三组患者在麻醉诱导前（T0）、气管插管前（T1）、气管插管后1min（T2）、3min（T3）和5min（T4）的SBP、DBP、HR和SpO2。结果 与T0时比较，T1时三组的BP均明显降低，A组和C组的HR下降（P<0.05）。与T1时比较，T2～ T4时A、B组的SBP和DBP明显升高，T2、T3时C组的SBP和DBP、T4时DBP升高，T2时三组、T3和T4时A组HR升高（P<0.05）。组间比较，T2时B、C组的SBP、C组的DBP低于A组；T2时C组的SBP低于B组；T3、T4时C组的SBP低于A组（P<0.05） 。结论 2%利多卡因超声雾化吸入可获得较完善表面麻醉效果，能明显减轻老年患者全麻气管插管引起血流动力学变化。
Objective To observe the effect of ultrasonic nebulization with 2％lidocaine for general anesthesia in the elderly.Methed Sixty elderly patients scheduled for epigastric surgery were randomly divided into 3 groups.Group A was control group,Group B received lidocaine 1.5mg/kg IV before intubation,Group C was given ultrasonic nebulization with 2％lidocaine before anesthesia induction.Invasive blood pressure,HR and SpO2 were recorded before anesthesia induction(T0),before intubation(T1) and at 1min(T2),3min(T3),5min(T4) after intubation.Results Compared with T0 ,BP in three groups and HR in group A and group C at T1 decreased significantly（P<0.05）. Compared with T1 ,SBP and DBP increased at T2-T4 in group A and group B, SBP and DBP increased at T2,T3 and DBP increased at T4 in group C,HR increased at T2 in three groups and at T3 ,T4 in group A（P<0.05）. SBP at T2 were lower in group B and group C than those in group A,SBP at T2 were lower in group C than those in group B,SBP at T3,T4 were lower in group C than those in group A（P<0.05）.Conclusion Ultrasonic nebulization with 2％lidocaine can provide enough topical anesthesia,which can relieve hemodynamic reactions evoked by intubation.

 

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