目的：评价复方利多卡因乳膏涂抹于气管导管表面，用于全麻甲状腺手术气管黏膜表面麻醉的有效性。方法前瞻随机双盲对照研究，连续纳入北京协和医院42例甲状腺部分或全切手术患者，随机分为对照组（ C组）和试验组（ L组）。将L组气管导管前1／2和套囊表面均匀涂布复方利多卡因乳膏（约2 g），C组导管表面涂抹石蜡油。研究终点为拔管期自发或诱发的（人为套囊放气充气）呛咳躁动事件。记录血流动力学指标，随访患者在麻醉恢复室（PACU）和住院期间并发症。结果拔管前的自发呛咳躁动率L组低于C组（15％和65％）（P＜0.01）；套囊放气充气试验阳性率L组低于C组（35％和90％）（P＜0.001）。带管期间发生血压或心率增加超过基线20％的发生率，L组有低于C组的趋势（1.65±1.26和5.57±2.06次／例）；拔管后1 min两组间收缩压与心率乘积，L组（12867±2169）低于C组（16385±2242）（P＜0.05）。结论对于全麻下甲状腺手术，气管导管表面涂抹复方利多卡因乳膏进行气管黏膜表面麻醉，能够有效减少全麻拔管期患者的呛咳和躁动，降低心血管应激。%Objective To evaluate the topical anesthetic effects of compound lidocaine cream ( CLC) coated endo-tracheal tube on the prevention of cough/agitation during extubation in thyroidectomy under general anesthesia . Methods 42 patients scheduled for thyroidectomy in Peking Union Medical College Hospital were continuously en -rolled in this prospective double-blinded randomized controlled trial .Patients were randomized into two groups . Group L were intubated with endotracheal tube coated with CLC , while the control group , group C with liquid par-affin .The end point of study was spontaneous or induced cough /agitation during extubation .Hemodynamic parame-ters and the consumption of opioids were recorded .Patients were followed for major complications during their stay in hospital .Results Spontaneous cough/agitation rate was lower in group L than group C ( 15% vs 65%, P<0.01 );so was induced cough/agitation (35%vs 90%, P<0.001 );the value of SBP ×HR was lower in group L at 1 min after extubation ( P<0.05 ) .Conclusions The topical anesthetic effects of CLC coated endotracheal tube could prevent cough and agitation during extubation in thyroidectomy under general anesthesia .
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