Inhibitory Effect Of Lidocaine Topical Anesthesia On The Hemodynamic Response Of Double Lumen Bronchial Tube Intubation

Background :To observe the effect of lidocaine topical anesthesia on the hemodynamic response of the intubation with double lumen bronchial tube in general anesthesia on the basis of epidural block.Method :Sixty patients with bronchial intubation under general anesthesia were randomly divided into control group and experimental group.After entering the room,the patients were connected with multifunctional monitor to monitor electrocardiogram,noninvasive arterial blood pressure and blood oxygen saturation,opened venous access,performed radial artery puncture,establish invasive blood pressure monitoring,underwent epidural block and give the test dose of 1% lidocaine 3ml.Midazolam 0.03mg/kg,cis-atracurium 0.2mg/kg,etomidate injection 0.25 mg/kg,sufentanil citrate injection 0.5 ug/kg were injected intravenously.Two minutes after induction,2%lidocaine 1 mg / kg was injected intravenously in the control group,and bronchial intubation was performed with GlideScope laryngoscope 1 minute.in the experimental group,after 2 minutes of general anesthesia induction,the consciousness of the patients disappeared and the glottis was exposed by laryngoscope.2% lidocaine 3ml was sprayed into trachea with one-off laryngeal anesthesia tube,then assisted ventilation was performed.bronchial intubation was performed with GlideScope laryngoscope after 1 minute of surface anesthesia.Recorded the change of systolic pressure,diastolic pressure,and heart rate in some time points:before induction,one minute before intubation,intubation immediately,one minute after intubation,three minutes after intubation,five minutes after intubation.Results :The systolic blood pressure and diastolic blood pressure in the experimental group were lower than that before induction at one minute before intubation,intubation immediately,one minute after intubation,three minutes after intubation,five minutes after intubation(P< 0.05);The systolic blood pressure in the control group was lower than before induction at one minute before intubation,one minute after intubation,three minutes after intubation,five minutes after intubation(P<0.05),the diastolic blood pressure was lower at one minute before intubation,three minutes after intubation,five minutes after intubation(P< 0.05),and the heart rate was lower at one minute beforeintubation and five minutes after intubation,(P< 0.05).The systolic blood pressure and diastolic blood pressure in the experimental group were lower than those in the control group at intubation immediately,one minute after intubation,three minutes after intubation,five minutes after intubation,the hear rate is lower at intubation immediately,five minutes after intubation,The difference was statistically significant(P<0.05).Conclusion:On the basis of epidural block,the effect of endotracheal surface anesthesia with 2% lidocaine is more significant than that of intravenous injection for inhibiting the response of double lumen bronchial tube intubation.