文章摘要
复方甘菊利多卡因凝胶对经鼻气管插管患儿术后气道相关并发症的影响
Effect of compound chamomile-lidocaine hydrochloride gel on airway-related complications in children undergoing nasotracheal intubation
  
DOI：10.12089/jca.2025.12.007
中文关键词: 经鼻气管插管  鼻出血  气道相关并发症  复方甘菊利多卡因凝胶  复方利多卡因乳膏  儿童
英文关键词: Nasotracheal intubation  Epistaxis  Airway-related complications  Compound chamomile-lidocaine hydrochloride gel  Compound lidocaine hydrochloride cream  Child
基金项目:
作者单位E-mail
乔岚歆 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
高铮铮 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
张迪 清华大学第一附属医院麻醉科  
訾婷婷 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
蔡黎明 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
王芳 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
张建敏 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科  
李立晶 100045,国家儿童医学中心,首都医科大学附属北京儿童医院麻醉科 amber1717@163.com 
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中文摘要:
      
目的：比较复方甘菊利多卡因凝胶与复方利多卡因乳膏改善经鼻气管插管患儿气道相关并发症的效果。
方法：选择2024年6—10月择期行全身麻醉下经鼻气管插管牙体牙髓治疗的患儿83例，男54例，女29例，年龄3～7岁，ASA Ⅰ或Ⅱ级。采用随机数字表法将患儿分为两组：复方甘菊利多卡因凝胶组（G组，n=42）和复方利多卡因乳膏组（C组，n=41）。气管插管前，G组和C组分别使用复方甘菊利多卡因凝胶和复方利多卡因乳膏涂抹气管导管套囊及套囊前部导管表面，进行充分润滑。记录气管插管次数、气管插管时间、气管导管留置时间、手术时间和麻醉时间。记录术后气道相关并发症的发生情况，包括鼻出血、屏气、呛咳、鼻咽痛、声音嘶哑及口咽黏膜炎。记录插管前即刻（T0）、插管后即刻（T1）、术毕（T2）、拔管后即刻（T3）及拔管后30 min（T4）的HR及MAP。
结果：与C组比较，G组术后鼻出血发生率和鼻出血严重程度分级明显降低，术后鼻咽痛及口咽黏膜炎发生率明显降低（P<0.05）。两组气管插管次数、气管插管时间、气管导管留置时间、手术时间、麻醉时间、术后屏气、呛咳、声音嘶哑发生率以及不同时点HR、MAP差异无统计学意义。
结论：与复方利多卡因乳膏比较，复方甘菊利多卡因凝胶用于患儿经鼻气管插管可以更有效降低气道相关并发症的发生率。
英文摘要:
      
Objective: To compare the effect of compound chamomile-lidocaine hydrochloride gel and compound lidocaine hydrochloride cream in mitigating airway-related complications in children undergoing nasotracheal intubation.
Methods: Eight-three children who underwent elective endodontic treatment through nasaltracheal intubation under general anesthesia from June to October 2024, 54 males and 29 females, aged 3-7 years, ASA physical status Ⅰ or Ⅱ, were selected in this stuty. The children were divided into two groups using random number table method: compound chamomile-lidocaine hydrochloride gel group (group G, n = 42) and compound lidocaine hydrochloride cream group (group C, n = 41). Before tracheal intubation, the compound chamomile-lidocaine hydrochloride gel in group G or the compound lidocaine hydrochloride cream in group C was applied to the surface and front part of the tracheal tube cuff for adequate lubrication. The number of tracheal intubations, the duration of tracheal intubation, the indwelling time of the tracheal catheter, the operation time, and the anesthesia time were recorded. The occurrence of postoperative airway complications, including epistaxis, breath-holding, choking cough, nasopharyngeal pain, hoarseness, and oropharyngeal mucositis were recorded. The HR and MAP were recorded immediately before intubation (T0), immediately after intubation (T1), at the end of the operation (T2), immediately after extubation (T3), and 30 minutes after extubation (T4).
Results: Compared with group C, the incidence of epistaxis and the severity classification of epistaxis in group G were significantly lower, the incidence of nasopharyngeal pain and oropharyngeal mucositis after extubation in group G was significantly reduced (P < 0.05). There was no statistically significant difference in the number of tracheal intubations, the duration of tracheal intubation, the indwelling time of tracheal catheters, the operation time, the anesthesia time, the incidence of breath-holding, choking cough, nasopharyngeal pain, hoarseness, and HR and MAP at different time points between the two groups.
Conclusion: Compared with compound lidocaine hydrochloride cream, compound ammonia-lidocaine hydrochloride gel used for nasal tracheal intubation can more effectively reduce the incidence of airway related complications in children.
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