The Application Of Lidocaine In Reducing Stress Reactions To The General Anesthesia Extubation

Aim:The aim of this study is to provide a simple and effective topical anesthesia method for tracheal extubation to inhibit the stress reaction by observing and comparing the different airway topical anesthesia methods.Methods:60 patients undergoing selective abdominal operations, ASAⅠ～Ⅱ, no cardio-cerebral-vascular diseases or diabetes,were randomly divided into three groups with 20 patients in each group:black control group(group A),not received any dispose; lidocaine hydrochloride gel smeared all over the cuff for endotracheal catheter before intubation(group B); the same dispose of group B plus oral, throat lidocaine topical anesthesia before extubation by the suction catheter(group C). General anesthesia was induced with fentanyl 2ug/kg, cisatracurium besilate 0.15mg/kg and propofol 2mg/kg, and the balanced anesthesia was maintained with propofol, remifentanil and isoflurane. The depth of anesthesia was controlled by the adjustment of the anesthetics according to hemodynamic changes. The hemodynamic parameters and the levels of neuronendocrine stress hormones, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean artery pressure (MAP), heart rate (HR), blood sugar (BS) and serum cortisol (CORT), were monitored and recorded intermittently at the different time points of the perioperative period, 5 minutes after entering the operation room, the end of the operation, immediately after extubation and 5 minutes later. We also recorded the cumulative amount of the anesthetics, the wake-up time, the incidence of agitation and bucking when extubation, and the satisfaction degrees.Results:There was no significant statistical difference in the basic conditions of the patients, the cumulative amount of the anesthetics and the wake-up time (P>0.05), whereas we observed that the extent of SBP, MAP, DBP, HR, BS and CORT of group B and C at the end of operation, immediately after extubation and 5 minutes later, changed less than those of group A (group C least), having a significant statistical difference (P<0.05). The incidence of agitation and bucking of group C was lower than those of group A (P<0.05), with no other anesthesia complication, but there was no significant statistical difference in the anesthesia satisfaction. Conclusion:The results show that topical anesthesia by lidocaine in multiway methods when extubation can reduce the cardiovascular stress reactions significantly and lower the incidence of agitation and bucking. It also can avoid the anesthesia complication, have a balanced extubation process, and raise the satisfaction more or less. In addition, this method is simple and reliable, mating no special instrument.