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学科主题临床医学
Spray-As-You-Go Airway Topical Anesthesia in Patients with a Difficult Airway: A Randomized, Double-Blind Comparison of 2% and 4% Lidocaine
Xue, Fu S.1,2,3; Liu, He P.3; He, Nong4; Xu, Ya C.1,2; Yang, Quan Y.1,2; Liao, Xu1,2; Xu, Xiu Z.4; Guo, Xin L.3; Zhang, Yan M.1,2
刊名ANESTHESIA AND ANALGESIA
2009-02-01
DOI10.1213/ane.0b013e31818f1665
108期:2页:536-543
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Anesthesiology
研究领域[WOS]Anesthesiology
关键词[WOS]AWAKE FIBEROPTIC INTUBATION ; LOCAL-ANESTHESIA ; SERUM CONCENTRATIONS ; TRAINING COURSE ; BRONCHOSCOPY ; LIGNOCAINE ; MANAGEMENT ; RESPONSES ; SEDATION ; CHILDREN
英文摘要

BACKGROUND: We designed this randomized, double-blind clinical study to compare the safety and efficacy of 2% and 4% lidocaine during airway topical anesthesia with a spray-as-you-go technique via the fiberoptic bronchoscope.

METHODS: Fifty-two adult patients with a difficult airway were randomly assigned to 1 of 2 study groups to receive 2% (Group 1) or 4% lidocaine (Group 2) by a spray-as-you-go technique with the fiberoptic bronchoscope, in a double-blind manner. After airway topical anesthesia, awake fiberoptic orotracheal intubation (FOI) was performed. Level of sedation, time for each lidocaine spray in different targeted areas, total times for airway sprays, total dosages of lidocaine used for airway sprays, intubation times, and number of intubation attempts were noted. An independent investigator scored patients′ comfort during airway topical anesthesia, patients′ reaction, coughing severity, and intubating condition during awake FOI, and observed changes of arterial blood pressure and heart rate during each stage in the airway manipulation process. Serial blood samples were obtained for analysis of plasma lidocaine concentrations.

RESULTS: Except for the total dosages and plasma concentrations of lidocaine, there were no significant differences in any of the observed variables between groups. All patients exhibited excellent or acceptable intubating conditions. The total dosages of lidocaine were significantly smaller in Group 1 (3.4 +/- 0.6 mg/kg) than in Group 2 (7.1 +/- 2.1 mg/kg). The plasma lidocaine concentrations in all observed points after the supraglottic sprays were larger in Group 2 than in Group 1.

CONCLUSIONS: Both 2% and 4% lidocaine administered topically by a spray-as-you-go technique can provide clinically acceptable intubating conditions for awake FOI in sedated patients with a difficult airway. As compared with 4% lidocaine, however, 2%, lidocaine requires a smaller dosage and results in lower plasma concentrations.

语种英语
WOS记录号WOS:000262590000024
引用统计
被引频次:54[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/50040
专题北京大学首钢医院
作者单位1.Chinese Acad Med Sci, Dept Anesthesiol, Plast Surg Hosp, Beijing 100144, Peoples R China
2.Peking Union Med Coll, Beijing 100144, Peoples R China
3.XinXiang Med Univ, Affiliated Hosp 3, Xinxiang, Henan, Peoples R China
4.Peking Univ, ShouGang Hosp, Beijing 100871, Peoples R China
推荐引用方式
GB/T 7714
Xue, Fu S.,Liu, He P.,He, Nong,et al. Spray-As-You-Go Airway Topical Anesthesia in Patients with a Difficult Airway: A Randomized, Double-Blind Comparison of 2% and 4% Lidocaine[J]. ANESTHESIA AND ANALGESIA,2009,108(2):536-543.
APA Xue, Fu S..,Liu, He P..,He, Nong.,Xu, Ya C..,Yang, Quan Y..,...&Zhang, Yan M..(2009).Spray-As-You-Go Airway Topical Anesthesia in Patients with a Difficult Airway: A Randomized, Double-Blind Comparison of 2% and 4% Lidocaine.ANESTHESIA AND ANALGESIA,108(2),536-543.
MLA Xue, Fu S.,et al."Spray-As-You-Go Airway Topical Anesthesia in Patients with a Difficult Airway: A Randomized, Double-Blind Comparison of 2% and 4% Lidocaine".ANESTHESIA AND ANALGESIA 108.2(2009):536-543.
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