鼻内镜术后复方利多卡因乳膏涂抹对术后疼痛的治疗效果

发布时间：2018-07-11 16:00

本文选题：复方利多卡因乳膏 + 鼻内镜手术　；参考：《中国微创外科杂志》2017年03期

【摘要】：目的探讨鼻内镜术后复方利多卡因乳膏涂抹于术后创面和鼻腔填塞物对鼻内镜术后疼痛的疗效。方法选择2015年4月~2016年6月我科全麻鼻内镜手术100例,随机分为A、B组,每组各50例。A组鼻内镜术后涂抹复方利多卡因乳膏4 g于鼻内手术创面及涂抹浸润医用膨胀海绵进行鼻内填塞;B组在鼻内镜术后涂抹生理盐水4 g于鼻内手术创面及涂抹浸润医用膨胀海绵进行鼻内填塞。观察术后拔管即刻(T0)、拔管后1 h(T1)、拔管后4 h(T2)、拔管后10 h(T3)、拔管后12 h(T4)心率(HR)、收缩压(SBP)、舒张压(DBP)的变化,记录拔管后疼痛视觉模拟评分(VAS)。结果 A组T0、T1、T2、T3时点HR、收缩压(SBP)、舒张压(DBP)明显低于B组(P0.05);T4时点2组HR、SBP差异无统计学意义(P0.05),A组DBP明显低于B组(t=-2.562,P=0.012)。T0、T1、T2、T3时点A组VAS评分明显小于B组(P=0.000),T4时点A组与B组VAS评分比较无统计学差异(t=-1.199,P=0.233)。结论鼻内镜术后涂抹复方利多卡因乳膏于创面和涂抹浸润复方利多卡因的鼻腔填塞物可以有效缓解鼻内镜术后鼻腔填塞的疼痛,取得良好的止痛效果,值得临床推广应用。
[Abstract]:Objective to investigate the effect of compound lidocaine cream on postoperative pain after nasal endoscopy. Methods from April 2015 to June 2016, 100 patients undergoing general anesthesia and endoscopic sinus surgery were randomly divided into group A and group B. Each group (n = 50) was treated with compound lidocaine cream (4 g) after endoscopic surgery. Group B (group B) was treated with saline 4 g after endoscopic surgery. Intranasal tamponade on the face and coated with medical intumescent sponge. The changes of heart rate (HR), systolic pressure (SBP) and diastolic pressure (DBP) were observed immediately after extubation (T0), 1 hour after extubation (T1), 4 hours after extubation (T2), 10 hours after extubation (T3), 12 hours after extubation (T4). The visual analogue score of pain after extubation (VAS) was recorded. Results there was no significant difference in HR-SBP, SBP and DBP between group A and group A (P0.05). DBP in group A was significantly lower than that in group B (T0. 562P0.012). T0T1T2T 3 was significantly lower than that in group B (P0. 000) and VAS in group A and group B were significantly lower than that in group B (P0. 000) and group B at T4 time point (P < 0. 05). The VAS score of group A was significantly lower than that of group A (P 0. 000). The VAS of group A was significantly lower than that of group B (P 0. 000). There was no statistical difference between the two groups (tl. 1. 1999, P < 0. 233). Conclusion the application of compound lidocaine cream on the wound and the nasal packing of compound lidocaine after nasal endoscopy can effectively relieve the pain of nasal cavity tamponade after nasal endoscopy and obtain good analgesic effect, which is worth popularizing in clinic.
【作者单位】：南京大学医学院附属南京鼓楼医院集团宿迁市人民医院麻醉科;南京大学医学院附属鼓楼医院麻醉科;南京大学医学院附属南京鼓楼医院集团宿迁市人民医院耳鼻喉科;
【分类号】：R614.2

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