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Received:July 24, 2024 Published Online:December 21, 2024
Received:July 24, 2024 Published Online:December 21, 2024
中文摘要: 目的 评估静脉注射不同剂量利多卡因在全麻下行支气管镜检查后对复苏期咳嗽的影响,以确定利多卡因最佳剂量。方法 采用前瞻性、单中心、随机对照临床试验方法,选取2023年9月至2024年6月南方医科大学顺德医院135例行支气管镜检查的患者,随机分为C组(生理盐水)、L1.0组(1.0 mg/kg利多卡因)、L1.5组(1.5 mg/kg利多卡因),每组45例。采用喉罩插管的全身麻醉,诱导后,分别静脉注射利多卡因和生理盐水。记录并分析拔除喉罩后30 min内咳嗽的发生情况,同时记录不良事件。咳嗽严重程度分为:轻度(单次咳嗽)、中度(持续超过5 s的多次咳嗽但无连续性)、重度(连续咳嗽超过5 s)。结果 C组、L1.0组、L1.5组患者复苏期咳嗽发生率分别为42.2%、22.2%和8.9%,三组间差异有统计学意义(χ2=13.72, P<0.01),两两比较经Bonferroni校正,L1.5组显著低于C组(χ2=13.14, P<0.01)。重度咳嗽发生率分别为17.8%、4.4%和2.3%,三组间差异有统计学意义(χ2=8.51, P<0.05)。与C组相比,L1.0组和L1.5组的术后恶心呕吐和咽喉痛发生率均显著降低(P<0.017)。结论 静脉注射1.5 mg/kg利多卡因能有效降低全麻下行支气管镜检查后复苏期咳嗽和重度咳嗽发生率,且显著减少恶心呕吐和咽喉痛的发生。
Abstract:Objective To evaluate the effect of intravenous injection of different doses of lidocaine on cough during the recovery period after bronchoscopy under general anesthesia, aiming to determine the optimal lidocaine dose. Methods Using prospective, single-center, randomized controlled clinical trial methods, a total of 135 patients who underwent bronchoscopy in Shunde Hospital of Southern Medical University from September 2023 to June 2024 were selected, and they were randomly divided into group C (normal saline), group L1.0 (1.0 mg/kg lidocaine), and group L1.5 (1.5 mg/kg lidocaine), with 45 cases in each group. All patients received general anesthesia with laryngeal mask. After induction, lidocaine or saline was administered intravenously. The incidence and severity of cough within 30 minutes after removal of the laryngeal mask were recorded and analyzed, along with adverse events. Cough severity was categorized as mild (single episode), moderate (multiple episodes lasting over 5 s but not continuous), and severe (continuous coughing lasting over 5 s). Results There was a statistically significant difference in the incidence of cough during the recovery period after bronchoscopy among the three groups: 42.2% in group C, 22.2% in group L1.0, and 8.9% in group L1.5 (χ2=13.72, P<0.01), and after Bonferroni correction, that in group L1.5 was significantly lower than that in group C (χ2=13.14, P<0.01). The incidence of severe cough was 17.8%, 4.4% and 2.3% respectively, and the difference among the three groups was statistically significant (χ2=8.51, P<0.05). Compared with group C, the incidence of postoperative nausea, vomiting and sore throat significantly reduced in group L1.0 and group L1.5 (P<0.017). Conclusion Intravenous injection of 1.5 mg/kg lidocaine can effectively decrease the incidence of cough during the recovery period after bronchoscopy under general anesthesia, and also can significantly reduce the occurrences of nausea, vomiting and sore throat.
文章编号: 中图分类号:R614.2 文献标志码:A
基金项目:广东省基础与应用基础研究联合基金(2023A1515140142);广东省普通高校重点科研平台和项目(2023ZDZX2008);广东省科学技术厅粤澳青年人才项目(粤科智字〔2022〕232号);佛山市科技创新项目(2320001007025)
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