文章摘要
徐林,喻乐,陈治军.静脉注射利多卡因联合右美托咪定对全麻下行甲状腺手术患者气管拔管时心血管反应的影响[J].中国医药导刊,2019,21(6):347-351.
静脉注射利多卡因联合右美托咪定对全麻下行甲状腺手术患者气管拔管时心血管反应的影响
Effects of Intravenous Lidocaine Combined with Dexmedetomidine on Cardiovascular Response to Tracheal Extubation in Patients Undergoing Thyroid Surgery under General Anesthesia
投稿时间:2019-04-22  修订日期:2019-06-19
DOI:
中文关键词: 利多卡因  右美托咪定  心血管反应  拔管
英文关键词: Lidocaine  Dexmedetomidine  Cardiovascular response  Extubation
基金项目:
作者单位E-mail
徐林 武汉市第一医院 95464453@qq.com 
喻乐 武汉市第一医院  
陈治军 武汉市第一医院  
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中文摘要:
      目的:探究静脉注射利多卡因联合右美托咪定对全麻下行甲状腺手术患者气管拔管时心血管反应的影响。方法:随机抽取2017年1~12月于我院气管插管全麻下行甲状腺手术患者120例,随机分为4组,A组(对照组),诱导前大于10 min静脉滴注100 mL生理盐水,拔管前2 min静脉注射2 mL生理盐水; B组(右美组),诱导前以1 μg·kg-1剂量右美托咪定稀释至100 mL生理盐水,大于10 min静脉滴注,拔管前2 min静脉注射2 mL生理盐水;C组(利多组),诱导前大于10 min静脉滴注100 mL生理盐水,拔管前2 min静脉注射1 mg·kg-1利多卡因;D组(利多联合右美组),诱导前以1 μg·kg-1剂量右美托咪定稀释至100 mL生理盐水,大于10 min静脉滴注,拔管前2 min静脉注射1 mg·kg-1利多卡因。分别观察每组患者入室、手术结束时、拔管时及拔管5 min时的心率、血压、呛咳等情况。结果:与A组相比,拔管时B组、C组、D组患者的呛咳反应发生率、心率血压变化幅度均减小,D组患者呛咳发生率更低,血流动力学变化更小。结论:气管插管全麻下行甲状腺手术患者静脉注射利多卡因联合右美托咪定可以有效抑制患者的拔管呛咳反应,并维持血流动力学的平稳。
英文摘要:
      Objective:To explore the effect of intravenous lidocaine combined with dexmedetomidine on cardiovascular response during tracheal extubation in patients undergoing thyroid surgery under general anesthesia. Methods: 120 patients undergoing thyroid surgery under tracheal intubation general anesthesia in our hospital from January 2017 to December 2017 were randomly divided into four groups. Group A (control group) was given intravenous drip of 100 mL saline before anesthesia induction more than 10 min,intravenous injection of 2 mL saline 2 minutes before extubation. Group B (dexmedetomidine group), dexmedetomidine was diluted to 100 mL saline at a dose of 1 μg·kg-1 for more than 10 min by intravenous drip before anesthesia induction, and intravenous injection of 2 mL saline 2 min before extubation. Group C (lidocaine group), intravenous drip of 100 mL saline more than 10 min before induction, and intravenous injection of 1 mg·kg-1 lidocaine 2 min before extubation. Group D (lidocaine combined with dexmedetomidine group), dexmedetomidine was diluted to 100 mL saline at a dose of 1 μg·kg-1 for more than 10 min by intravenous drip before induction,and intravenous injection of 1 mg·kg-1 lidocaine 2 min before extubation. Heart rate, blood pressure and cough were observed at the time of entering the operating room, at the end of the operation, at the time of extubation and 5 min after extubation. Results: Compared with the control group (group A), the incidence of chocking cough and the change of heart rate and blood pressure in group B, C and D decreased, and the incidence of chocking cough and hemodynamic changes decreased more in group D. Conclusion:Intravenous lidocaine combined with dexmedetomidine can effectively inhibit extubation chocking cough response and maintain hemodynamic stability in patients undergoing thyroid surgery under tracheal intubation general anesthesia.
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