Objective: To observe the effect of compound lidocaine cream combined with preoperative psychological intervention on perioperative hemodynamics,anesthesia recovery and postoperative complications in patients with laryngeal mask airway general anesthesia.Methods: 120 ASA Ⅰ or Ⅱ patients undergoing orthopaedics internal fixation removal operation under general anesthesia were randomly allocted into four groups(n=30): control group(C group),compound lidocaine cream treatment group(L group),preoperative psychological intervention group(X group) and compound lidocaine cream plus preoperative psychological intervention group(LX group).Philips multifunction monitor continuous monitoring of heart rate(HR),surplus pulse O2(SpO2) and blood pressure(BP).Recorded SpO2,mean arterial pressure(MAP) and HR respectively at various time points: the baseline when entering the operation room(T0),when laryngeal mask inserting(T1),1 min after laryngeal mask inserting(T2),5 min after laryngeal mask inserting(T3),when the patient awake(T4),when pulling out the laryngeal mask airway(T5),1 min after pulling out the laryngeal mask airway(T6),5 min after pulling out the laryngeal mask airway(T7),10 min after pulling out the laryngeal mask airway(T8).The time of postoperative recovery,degree of coordination and agitation,the incidence of postoperative adverse reaction such as sore throat or throat discomfort were monitored and recorded. Results: Compared with group C,the degree of stimulation were significantly lower in group L,group X and group LX(P<0.05),especially in group LX(P<0.01),and the blood pressure and heart rate were more stable during the recovery period;the coordination degree and postoperative satisfaction in group L,group X and group LX were significantly higher than that in group C,the time of pulling out the laryngeal mask airway was significantly shortened,postoperative complication rate was decreased significantly(P<0.05),especially in group LX(P<0.01);compared with the same time point of group L and group X,MAP at T4-T8 was significantly lower and more stable in group LX,the agitation had significant difference at 0-3 grades(P<0.05).Postoperative throat discomfort,pain,hoarseness and other complications were decreased significantly in group LX(P<0.05). Conclusion: Compound lidocaine cream combined with preoperative psychological intervention can effectively inhibit postoperative agitation and cardiovascular adverse reaction,shorten the extraction time of laryngeal mask airway,reduce the incidence of postoperative complications,provide safety for the patients during the laryngeal mask airway general anesthesia perioperative period for orthopaedics internal fixation removal surgery. |
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