COMPARISON OF LOWER CONCENTRATIONS OF LIDOCAINE TO SUPPRESS BUCKING BEFORE EXTUBATION DURING RECOVERY OF GENERAL ANESTHESIA

比較低濃度Lidocaine在全身麻醉的恢復期抑制拔管前病人的咳嗽

吳宗正(Tzong-Jeng Wu) ； 劉健強(Chien-Chiang Liu) ； 林仙養(Shian-Yeang Lin) ； 江洽榮(Chung-Jong Jiang) ； 陳欽隆(Chin-Long Chen) ； 侯文詠(Wen-Yeong Hou)梁恆彰(Hen-Chang Liang) ； 李宗勳(Tzong-Shiun Lee) ； 黃啟祥(Chi-Hsiang Huang) ； 洪柏園(Po-Yuan Hong) ； 林珍榮(Luciana Susetio) ； 黃芳彥(Fan-Yen Huang) ； 趙繼慶(Chi-Ching Chao)

《Acta Anaesthesiologica Sinica》 28卷3期 (1990/09) Pp. 279-283

摘要

Thirty females, aged 25-50 years old, scheduled for abdominal total hysterectomy were randomly divided to two groups. For patients in group I, 2 mL 1% lidocaine solution was injected through the catheter on the tube to desensitize the trachea while surgeon started to close the peritoneum. In group II, 2 mL 2% lidocaine was used. The peak cuff pressures generated in the awakening group I patients were 49 .0±2.5 cmH_2O (mean±SD) which shows greater than that in group II (27.9±7.2 cmH_2O), p ＜ 0.01. Bucking before awakening was also evaluated clinically. One hundred % (15/15) in group I patients bucked compared with 13.3% (2/15) in group II patients (p ＜ 0.01). Gag reflex was preserved in all patients and none suffered from aspiration postoperatively. Intratracheal administration of two mL 2% lidocaine through the catheter of modified endotracheal tube showed significant effect for suppressing bucking during recovery of general anesthesia.

關鍵字

Endotracheal tube ； Lidocaine

並列摘要

本實驗將三十位接受全子宮切除術的婦科病人分為二組。全部病人都使用改良型氣管內管。對第一組病人，在外科醫師開始，縫合腹膜時，吾人將2 mL 1% Lidocaine經導管注入氣管內管上氣囊的周圍，以減少氣囊對氣管的刺激；第二組則以2 mL 2% Lidocaine。手術結束後，在病人清醒前，連續測量氣管內管上氣囊的最高壓力以代表咳嗽（Bucking）的程度。所有病人都於麻醉結束，清醒後才拔管。結果顯示，清醒前的咳嗽程度（氣囊的最高壓力），在第二組病人（27.9±7.2 cmH_2O，mean±SD）比第一組（49.0±2.5 cm H_2O），統計上有意義地減低（p ＜ 0.01，見表二）。全部病人在拔管前後都仍保有Gag reflex的能力，術後都沒有發現Aspiration的現象。