利多卡因对全麻患者气管插管时血流动力学影响.docVIP

利多卡因对全麻患者气管插管时血流动力学影响[摘要] 目的 观察利多卡因对全麻患者气管插管时血流动力学的影响。方法 将60例全麻患者随机分为两组：A组为利多卡因组，B组为对照组，诱导药物均为咪达唑仑+芬太尼+维库溴铵+异丙酚，A组加用利多卡因。观察两组患者诱导前、插管时、插管后及2min、5min的收缩压、心率的变化及其他病情变化。结果 A组插管时收缩压、心率明显低于B组（P＜0.01），插管后及2min、5min心率明显低于B组（P＜0.01），插管后收缩压低于B组（P＜0.05）。结论 利多卡因能够有效地预防全麻患者气管插管时由心血管应激反应而引起的血流动力学改变。 [关键词] 利多卡因；气管插管；血流动力学 [中图分类号] R614.42[文献标识码] A[文章编号] 1673-9701（2009）12-111-02 Influence of Lidocaine on Hemodynamics when Patients Receive Endotracheal Intubation GU WentongZHANG JianhuaHUANG Man Department of Aneathesia，Center Hospital of Jiangmen City，Guangdong 529030 [Abstract] Objective To observe the influence of Lidocaine on hemodynamics when patients receive endotracheal intubation. Methods60 patients were randomly devided into Lidocaine group（A group） and control group（B group）. Both of the anaesthesia inductive medicine were midazolan，fentanyl，vecuronium and propofol. Lidocaine was added into A group additionally. To observe their changes of SBP and heart rate（HR） before anaesthesia induction， and the 2 minutes and 5 minutes after endotracheal intubation. Results The SBP and（HR） of A group were obviously lower than B group（P＜0.01） at the time of endotracheal intubation. The heart rate of A group was obviously lower than B group 2 minutes and 5 minutes after endotracheal intubation（P＜0.01）. The SBP of A group was lower than B group after endotracheal intubation（P＜0.05）. Conclusion Lidocaine can effectively prevent the change of hemodynamics that was caused by cardiovascular stress response when the patients receive endotracheal intubation. [Key Words] Lidocaine；Endotracheal intubation；Hemodynamics 随着现代医学的进步和发展以及医疗水平的不断提高，在各级医院进行全麻气管插管的患者和手术也越来越多。全麻气管插管时对患者的血流动力学影响也比较大。本组患者在全麻诱导过程中应用利多卡因，以期达到减少患 者血流动力学变化的目的，现将结果报道如下。 1材料与方法 1.1一般资料 选择我院2008年1～12月的60例ASA I～II级的成人全麻患者的病例资料，患者的年龄、性别、体重等术前情况无明显差别。 1.2方法 将60例患者随机分为两组：A组30例患者为利多卡因组，B组30例患者为对照组；术前常规用药为海俄辛和鲁米那，入手术室后开通静脉，静滴乳酸钠林格氏液，吸氧去氮，保持血氧饱和度在97%以上，开始麻醉诱导，用药为咪达唑仑0.1mg/kg+芬太尼0.04mg/kg+维库溴铵0.1mg