Effecting Study Of Surface Anesthesia With Drug Injection Endotracheal Tube On The Stress Response In General Anesthesia

Research background and purpose:To maintain the patient’s airway patency and ensure smooth oxygen supply and ventilation during general anesthesia,tracheal intubation is usually used to ensure the airway is open.However,the catheter left in the airway can stimulate the movement of the catheter during intubation and extubation,causing adverse reactions in general anesthesia patients,such as coughing,struggling,sympathetic nervous system excitation,and a surge in activity of the hypothalamic pituitary adrenal axis,increasing the burden on the cardiovascular system.This randomized controlled trial aims to use an injection type multifunctional tracheal catheter to spray different formulations of local anesthetics,observe the stress response and related complications of patients during tracheal extubation,and explore the safety and effectiveness of surface anesthesia using an injection type multifunctional tracheal catheter.Materials and Methods:From February 2022 to August 2022,the First People’s Hospital of Neijiang City plans to perform laparoscopic cholecystectomy on 150 patients.Using a random number table,the patients were divided into the lidocaine group（Group L）.5min before the end of the surgery,2ml of 2%lidocaine injection was administered to the patients through two injection capsules on the injection type tracheal catheter;The lidocaine combined with betamethasone group（Group LB）was administered 2%lidocaine injection combined with compound betamethasone injection through two injection capsules on an injection type tracheal catheter 5 minutes before the end of the surgery,with a 1:1 mixture of 2ml;Physiological saline group（Group C）:5min before the end of the surgery,patients were given 2ml of 0.9%physiological saline through two injection capsules on the injection type tracheal catheter.After suturing the skin,the patient used 100mg of ropivacaine to infiltrate and anesthetize the area around the incision.At the end of the operation,the patient was transferred to PACU until the muscle relaxation monitoring value TOFr>0.9 and the patient was able to raise his head,open his eyes and answer questions according to the instructions of the observer in the recovery room.The respiratory rate was>12 times/minute.After 5 minutes of stopping oxygen inhalation,the Sp O2 was>95%,and then the sputum was aspirated and the tube was pulled out.Systolic pressure（SBP）,diastolic pressure（DBP）,mean arterial pressure（MAP）,heart rate（HR）were recorded before anesthesia（T₀）,immediately before extubation（T₁）,immediately after extubation（T₂）,and 5 minutes after extubation（T₃）.venous blood was drawn at T₀,T₂,and T₃ to measure the plasma cortisol（Cor）value and blood glucose value,and to evaluate the RIKER sedation and restlessness score,cough score,and VRS score of pharyngeal pain of patients immediately after extubation,Observe whether the patient experiences symptoms of pharyngeal discomfort and respiratory complications within 24hours after surgery.Result:There was no statistically significant difference in gender,age,body mass index（BMI）,ASA grade,history of hypertension,coronary heart disease,surgical time,and anesthesia time among the three groups of patients in general data（P>0.05）.Compared between the three groups,the systolic blood pressure,diastolic blood pressure,mean arterial pressure,and heart rate of the L group and the LB group were lower than those of the C group at T₂ and T₃,with statistically significant differences（P<0.05）.However,there was no significant difference between the L group and the LB group（P>0.05）;The Cor values of L group and LB group were lower than those of C group after extubation,and the difference was statistically significant（P<0.05）.Tube tolerance:The incidence of coughing in the L and LB groups was lower than that in the C group,with a statistically significant difference（P<0.05）,but there was no significant difference between the L and LB groups（P>0.05）;The incidence of throat swelling and pain 24 hours after surgery was significantly higher in Group C than in Group L and Group LB（P<0.05）.There was no statistically significant difference in blood glucose changes at the three time points during surgery（P>0.05）.Conclusion:1.Using an injection type tracheal catheter for surface anesthesia can effectively suppress stress response during extubation and maintain hemodynamic stability.2.There was no significant difference in the inhibitory effect of surface anesthesia using 2%lidocaine injection and compound betamethasone injection combined with 2%lidocaine mixture on stress response during extubation,but the incidence of postoperative pharyngeal complications was lower in patients treated with compound betamethasone.