Zhang Xuemei,Gao Zhengzheng,Sun Lan,et al.Comparison of the efficacy of lidocaine hydrochloride gel paste versus compound lidocaine cream in alleviating pharyngeal adverse reactions in children after general anesthesia with laryngeal mask airway[J].Journal of Clinical Pediatric Surgery,,23():1180-1185.[doi:10.3760/cma.j.cn101785-202312032-013]
Comparison of the efficacy of lidocaine hydrochloride gel paste versus compound lidocaine cream in alleviating pharyngeal adverse reactions in children after general anesthesia with laryngeal mask airway
- Keywords:
- Lidocaine; Lubricants; Anesthesia; General; Laryngeal Mask Airway; Adverse Reaction; Side Effect; Child
- Abstract:
- Objective To observe the efficacy of lidocaine hydrochloride gel paste versus compounded lidocaine cream as surface lubricants in reducing adverse pharyngeal reactions after general anesthesia by laryngeal mask in children. Methods For this single-center prospective single-blind randomized controlled study,90 children underwent elective removal of internal fixation after funnel chest surgery from May 2023 to August 2023.Aged 8 to 15 years with ASA classification Ⅰ-Ⅱ,they were randomized into two groups of lidocaine hydrochloride gel paste (L,n=45) and compounded lidocaine cream (F,n=45).Specific medications were applied evenly to front and back of laryngeal mask preoperatively.Number of successful mask insertions,time of successful insertion,hemodynamic changes of heart rate (HR) and mean arterial pressure (MAP) at the time of entering operation room (T0),moment of laryngeal mask insertion (T1) and moment of laryngeal mask removal (T2) were recorded.The presence of hoarseness,choking,laryngospasm and oropharyngeal mucositis at the moment of removing mask; sore throat at 10 min,30 min,2h and 6h after removing mask; the occurrence of adverse pharyngeal reactions within 2h after removing mask were recorded. Results Based upon numerical rating scale (NRS),the incidence of sore throat in group L was lower than that in group F at 10 min after removing mask ; and the incidence of sore throat was lower in group L than that in group F at 30 min [8.9%(4/45) vs.26.7%(12/45)] and the difference was statistically significant (P<0.05).The incidence of adverse pharyngeal reactions was lower in group L than that in group F [16%(7/45) vs.38%(17/45)] at 2 h after removing mask with a statistically significant difference (P<0.05).Regarding the incidence of protective pharyngeal reflex restriction,group L was lower than group F with [6.7%(3/45) vs.22.2%(10/45)] a statistically significant difference (P<0.05). Conclusions Usage of lidocaine hydrochloride gel paste as a laryngeal mask lubricant may lower the incidence of sore throat after mask removal and reduce adverse pharyngeal reactions in children.Protective pharyngeal reflex recovers faster so as to facilitate an accelerated recovery.
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Memo
收稿日期:2023-12-14。
通讯作者:李立晶,Email:amber1717@163.com