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| 不同剂量硝酸甘油复合利多卡因对女性桡动脉直径及穿刺置管的影响 |
| Effects of nitroglycerin combined with lidocaine on the diameter of female radial artery and puncture catheterization |
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| DOI：10.12089/jca.2021.11.008 |
| 中文关键词: 硝酸甘油 利多卡因 女性 桡动脉直径 |
| 英文关键词: Nitroglycerin Lidocaine Female Radial artery diameter |
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| 中文摘要: |
目的 探讨皮下注射不同剂量硝酸甘油复合利多卡因对女性患者桡动脉直径及穿刺置管的影响。
方法 选择择期手术拟行桡动脉穿刺置管术的女性患者149例，年龄18～65岁，ASA Ⅰ或Ⅱ级。采用随机数字表法将患者分为三组：硝酸甘油复合利多卡因1组（NL1组，n=50），硝酸甘油复合利多卡因2组（NL2组，n=49）和对照组（C组，n=50）。选择左侧桡骨茎突近端2 cm处作为皮下注射点，NL1组皮下注射0.5 ml硝酸甘油25 μg+0.5 ml利多卡因10 mg；NL2组皮下注射0.5 ml硝酸甘油50 μg+0.5 ml利多卡因10 mg；C组皮下注射0.5 ml生理盐水+0.5 ml利多卡因10 mg。记录给药前即刻、给药后2、5、10和15 min时桡动脉直径、HR、MAP。记录置管次数、穿刺次数、穿刺时间,计算首次置管成功率。记录桡动脉痉挛、血肿发生情况。
结果 与给药前即刻比较，给药后2、5、10和15 min时NL1组、NL2组桡动脉直径明显增大（P<0.05）。不同时点C组桡动脉直径差异无统计学意义。不同时点三组HR、MAP差异无统计学意义。给药后2、5、10、15 min，NL1组、NL2组桡动脉直径明显大于C组（P<0.05），首次置管成功率明显高于C组（P<0.05），穿刺次数明显少于C组（P<0.05），穿刺时间明显短于C组（P<0.05），桡动脉痉挛和血肿发生率明显低于C组（P<0.05）。 给药后2、5、10和15 min NL2组桡动脉直径明显大于NL1组(P<0.05)。NL2组首次置管成功率明显高于NL1组(P<0.05)，穿刺次数明显少于NL1组(P<0.05)，穿刺时间明显短于NL1组(P<0.05)。
结论 皮下注射硝酸甘油50 μg复合利多卡因10 mg较硝酸甘油25 μg复合利多卡因10 mg能更有效地扩张桡动脉直径，提高穿刺置管成功率，减少穿刺并发症，对患者血流动力学无明显影响。 |
| 英文摘要: |
Objective To investigate the effects of subcutaneous injection of different doses of nitroglycerin combined with lidocaine on the diameter of female radial artery and puncture catheterization.
Methods A total of 149 female patients undergoing elective surgery, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were scheduled for radial arterial catheterization. Patients were divided into three groups by using a random number table method: nitroglycerin combined with lidocaine group1 (group NL1, n = 50), nitroglycerin combined with lidocaine group2 (group NL2, n = 49) and control group (group C, n = 50). 1 cm proximal to the left radial styloid was selected as subcutaneous injection point. Group NL1: subcutaneous injection of 25 μg nitroglycerin 0.5 ml + 10 mg lidocaine 0.5 ml; group NL2: subcutaneous injection of 50 μg nitroglycerin 0.5 ml + 10 mg lidocaine 0.5 ml; group C: subcutaneous injection of normal saline 0.5 ml + 10 mg lidocaine 0.5 ml. The diameter of the radial artery, blood pressure, and heart rate immediately before administration, 2, 5, 10, 15 minutes after administration were recorded; the first attempt success rate, the number of attempts, successful cannulation time were recorded; the occurrence of radial artery spasm and hematoma were recorded.
Results Compared with the moment immediately before giving nitroglycerin compound lidocaine, the diameter of radial artery increased significantly 2, 5, 10, 15 minutes after giving nitroglycerin compound lidocaine in groups NL1 and NL2 (P < 0.05), and there was no significant difference in the diameter of radial artery in group C. Compared with the moment upon giving nitroglycerin compound lidocaine, there was no significant difference 2, 5, 10, 15 minutes after giving nitroglycerin compound lidocaine in MAP and HR in any group. Patients in groups NL1 and NL2 2, 5, 10, 15 minutes after giving nitroglycerin compound lidocaine had a larger radial artery diameter (P < 0.05), a higher first attempt success rate (P < 0.05), fewer placement attempts (P < 0.05), shorter successful cannulation time (P < 0.05), a lower incidence of the radial artery spasm and hematoma than that in group C (P < 0.05), respectively. Patients in group NL2 2, 5, 10, 15 minutes after giving nitroglycerin compound lidocaine had a larger radial artery diameter (P < 0.05), a higher first attempt success rate (P < 0.05), fewer placement attempts (P < 0.05), shorter successful cannulation time than that in group NL1 (P < 0.05).
Conclusion Subcutaneous injection of 50 μg nitroglycerin combined with 10 mg lidocaine is more effective than subcutaneous injection of 25 μg nitroglycerin combined with 10 mg lidocaine in terms of expanding the diameter of the radial artery, improving the success rate of puncture catheterization, reducing puncture complications, which has no effect on the patient's hemodynamics. |
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