Effect Of Different Administration Methods Of Lidocaine On Extubation Period Of General Anesthesia Patients

Objective:In this study,lidocaine was administered in different ways 5 minutes before extubation to observe the hemodynamic changes and the degree of cough caused by airway stress response before and after extubation during the recovery period of patients under general anesthesiaMethods:The ASA grade I-II,age 40-70 years,60 patients undergoing elective general anesthesia were selected as the subjects.After the patient enters the operating room,Routine anesthesia induction,Mechanical ventilation after successful intubation,Intraoperative use of propofol combined with remifentanil pump for anesthesia maintenance,And no muscle relaxants30 min before surgery,No muscle relaxation antagonism was performed on neostigmine during extubation,Five min before extubation were given lidocaine in different ways,After the oral suction sputum,After the patient wakes up completely,suction sputum and extubation in the airway.The patients were divided into three groups by randomized grouping: A group(n=20): intravenous lidocaine 1.0 mg/kg;5 min before extubation B group(n=20): lidocaine airway surface anesthesia 1.0 mg/kg;5 min before extubation C group(n=20): no treatment.The heart rate,blood pressure and mean arterial pressure of three groups were recorded after entering(T1),5 minutes before extubation(T2),5 min after extubation(T4),Comparison of sputum aspiration before extubation and cough during extubation in three groups,Postoperative sedation scores and extubation,such as restlessness,laryngeal spasm,etc.Results:There was no statistical difference in age,height,weight and BMI among the three groups(P > 0.05).At T3 and T4,the mean arterial pressure and heart rate of group A and group B were lower than that of group C,and group B was lower than that of group A.The cough degree of sputum suction and tube pulling was observed.The cough degree of group A and group B was lighter than that of group C,and group B was better than group A.The score of postoperative sedation in group A was higher than that in group B and C.There was no statistically significant difference in the incidence of postoperative adverse events(P>0.05).No adverse events occurred in Group A and Group B,and two patients in Group C had adverse events.Conclusion:The stimulation to the laryngopharynx and trachea during sputum aspiration and tube withdrawal can be effectively controlled by intravenous or airway surface anesthesia with 1.0mg/kg lidocaine 5min before sputum aspiration and tube withdrawal,and the hemodynamic stability can be maintained.Moreover,airway surface anesthesia before sputum aspiration and tube extubation has better effect.