The Impact On The Operative Field Clarity And Blood Pressure Heart Rate While Local Infiltration Under Nasal Mucosal Of Lidocaine Containing Single Or Combine Of Epinephrine Receptor Agonists In Transsphenoidal Pituitary Resection

Objective:The impact on the operative field clarity, blood pressure and heart rate while local infiltration under nasal mucosal of lidocaine containing single or combine of epinephrine receptor agonists in transsphenoidal pituitary resectionMethods:92 patients undergoing general anesthesia in transsphenoidalpituitary tumor resection were divided into 4 groups,23 cases in each group. Local infiltration of lidocainecontaining with single or combineof adrenergic receptor agonist(epinephrine or norepinephrine) under nasal mucosa. The groupl contains epinephrine 2μg/ml, group Ⅱ containing norepinephrine 1 μg/ml, groupⅢcontaining norepinephrine 0.5μg/ml+epinephrine 1μg/ml, groupIVonely containing 1% lidocaine. The injection volume according to 0.2mg/kg. Contimue monitoring the ECG, HR, SBP, DBPand end expiratory gas detection intraoperation. Recorded after the start of injection Omin(baseline) and after the injection of 0.5min, lmin,1.5min,2min,2.5min,3min, 3.5min,4min,4.5min,5min,5.5min each point of blood pressure, arterial pressure, heart rate, ECG, and the operation time, the clarity of the operative field, and the postoperative adverse consequences.Results:Compared with the baseline, group Ⅰ,groupII,groupIII,groupIV were observed in all the hemodynamic fluctuations, Ⅰ～Ⅱ group are more intense. Group I the BP decreased and HR increased significantly between 1.5-2.0min, and after about 3min recovered to the level before. GroupⅡ the MAP increased and HR decrease, continue about 4min,then trends to the baseline. GroupⅢ the two peak of MAP 0.5min and 3min groupsⅢ. HR first increased quickly after slows down below the baseline and to start rising at 3.5min trends to baseline; In groupⅣ, the BP and HR increased after injection, and 1 min returned to the baseline. Every group compared with there own baseline, the fluctuation amplitudegroup Ⅰ>groupⅡ>groupⅢ>groupⅣ.Conclusion:Local infiltration under nasal mucosal of lidocaine containing single or combine of epinephrine receptor agonists in transsphenoidal pituitary resection can improve the clarity of the operative field, shorten the operation time, but has a significant effect on blood pressure and heart rate. And alone use of lidocaine has little effect on hemodynamics. The group lidocaine combine containing epinephrine receptor agonistshas less impact on blood pressure and heart rate.