摘要
目的观察七氟烷吸入复合利多卡因表面麻醉用于经鼻纤维支气管镜插管(FOB)的效果。方法 ASAⅠ、Ⅱ级,择期行颈椎手术的患者40例,随机分为4%七氟烷吸入组(S组)和4%七氟烷吸入复合2%利多卡因表面麻醉组(SL组),记录吸入诱导前基础值(T0)、FOB插管前即刻(T1)、插管后1 min(T2)、插管后3 min(T3)、插管后5 min(T4)时的平均动脉压(MAP)、心率(HR)、脑电双频指数(BIS)。结果与T0比较,两组T1时的MAP、HR均明显下降(P<0.05)。S组MAP、HR在T2、T3较T1明显升高(P<0.05)。SL组MAP、HR在T2、T3较T1有所升高,但差异无显著性(P>0.05),且与S组相比,升高幅度较低(P<0.05)。两组的BIS值在T1～T4与T0比均明显下降(P<0.05),但两组T1～T4时间点组内及组间差异无显著性(P>0.05)。结论七氟烷吸入复合利多卡因表面麻醉能有效抑制经鼻纤维支气管镜插管反应,安全可行。
【Objective】To observe clinical effects of inhaled induction with sevoflurane combined with lidocaine topical anesthesia for nasal fiberoptic intubation.【Methods】Forty patients,ASA Ⅰ-Ⅱ,who were scheduled for cervical spine surgery were randomised to 4% sevoflurane group（Group S） or 4% sevoflurane combined with 2% li-docaine topical anesthesia group（Group SL）.Hemodynamic data of mean arterial pressure（MAP） and heart rate（HR）,bispectral index（BIS） were recorded at T0 base line before induction,T1 just before fiberoptic bronchoscopy（FOB） intubation,T2 1 min after intubation,T3 3 min after intubation,T4 5 min after intubation.【Results】Compared with T0,MAP,HR at T1 decreased significantly both groups（P 0.05）.MAP,HR at T2,T3 was significantly higher than T1 in Group S（P 0.05）.Compared with T1,MAP,HR at T2,T3 was increased but there was no significantly dif-ference in Group SL（P 0.05）,and compared with the Group S,MAP,HR at T2,T3 in Group SL were lower（P 0.05）.BIS value in the T1 ~ T4 was significantly decreased compared with T0 both groups（P 0.05）,but there were no significantly difference at T1 ~ T4 both groups and between groups（P 0.05）.【Conclusions】Our study demon-strates the feasibility and safety of inhalational induction with sevoflurane combined with lidocaine topical anesthesi-a,and suppressed hemodynamic changes sufficiently during nasal fiberoptic intubation.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第12期1257-1260,1265,共5页
China Journal of Endoscopy
关键词
七氟烷
吸入诱导
表面麻醉
纤维支气管镜
sevoflurane
inhaled induction
topical anesthesia
fiberoptic bronchoscopy
