| ObjectivesObjective To observe and compare the clinical effects of endotracheal intubation with different smearing range of Oxybuprocaine Hydrochloride Gel on dental caries in preschool children under general anesthesia,in order to find a safe and effective nasal endotracheal intubation for children with dental caries under general anesthesia.MethodAccording to the inclusion and exclusion criteria,300 preschool children with dental caries treated under general anesthesia in the Department of children’s stomatology of Nanjing Maternal and child health hospital from September 2018 to January 2020 were selected as the research objects.The research objects were randomly divided into the control group(Paraffin Oil 1 group,paraffin oil 2 group,paraffin oil 3 group)and the experimental group(olbcain 1 group,olbcain 2 group,olbcain 2 group)There were 50 cases in each group.Paraffin oil 1 groups,paraffin oil 2 groups and paraffin oil 3 groups were smeared with stone wax oil at the front of tracheal catheter 1/4,1/3 and 1/2 respectively.The way and range of Oxybuprocaine Hydrochloride Gel coated with orcovin 1 groups,orb group 2 and orb group 3 were the same as those of paraffin oil 1 group,paraffin oil 2 group and paraffin oil 3 group.The changes of mean arterial pressure(map)and heart rate(HR)before anesthesia induction(TO),after anesthesia induction(T1),during tracheal intubation(T2),10 min after tracheal intubation(T3),20 min after tracheal intubation(T4),during tracheal extubation(T5),10 min after tracheal extubation(T6),20 min after tracheal extubation(T7)were compared Scale,VAS)were used to evaluate the degree of pain in nasal cavity and throat at 1 h and 2 h after extubation,and other complications,such as epistaxis during tracheal intubation,cough during tracheal extubation and hoarseness after operation,were compared and analyzed.Results:1.Comparison of basic data of each groupThere was no significant difference in gender,age,body mass(BMI),number of dental caries and operation time between the six groups(P>0.05).The anesthesia methods,anesthetic drugs and American Society of anesthesiologists(ASA)anesthesia grades were the same in each group.2.Comparison of hemodynamic indexes2.1 Comparison of MAP among groupsThrough the comparison of MAP between the six groups,it was found that there was no significant difference in MAP at T0,T1,T4 and T7(P>0.05),but there was significant difference in MAP at T2,T3,T5 and T6(P<0.05).2.1.1 Comparison of MAP between olbcaine group and paraffin oil groupThere were significant differences in MAP at T2 and T3 between olbucaine 1 group and paraffin oil 1 group(P<0.05),that is,at the time of endotracheal intubation and 10 minutes after endotracheal intubation,olbucaine 1 group was better than paraffin oil 1 group;there were significant differences in MAP at T2,T3,T5 and T6 between olbucaine 2 group and paraffin oil 2 group(P<0.05)At the time points of tracheal intubation,10 min after tracheal intubation,tracheal extubation and 10 min after tracheal extubation,the MAP of olbcaine group 2 was better than that of paraffin oil group 2;the MAP of T2,T3,T5 and T6 of olbcaine group 3 and paraffin oil group 3 were statistically significant(P<0.05),that is,at the time of tracheal intubation,10 min after tracheal intubation,tracheal extubation and 10 min after tracheal extubation At these time points,olbcaine 3 group was better than paraffin oil 3 group.2.1.2 Comparison of MAP among olbcaine groupThere were statistically significant differences in the MAP of T3 and T5 between group 1 and group 2(P<0.05),that is,at 10 minutes after tracheal intubation and at extubation,group 2 was better than group 1;there were statistically significant differences in the MAP of T2,T3,T5 and T6 between group 1 and group 3(P<0.05))At the time points of tracheal intubation,10 minutes after tracheal intubation,tracheal extubation and 10 minutes after tracheal extubation,the MAP of group 3 was better than that of group 1;the MAP of group 2 was significantly different from that of group 3 at T2 and T6(P<0.05),group 3 was better than group 2.2.2 Comparison of HR among groupsThrough the comparison of HR among the six groups,it was found that there was no significant difference in HR at T0,T1,T4 and T7(P>0.05),but there was significant difference in HR at T2,T3,T5 and T6(P<0.05).2.2.1 Comparison of HR between olbcaine group and paraffin oil groupThere was significant difference in HR at T3 between olbcaine group 1 and paraffin oil group 1(P<0.05),that is,at 10 minutes after tracheal intubation,olbcaine group 1 was better than paraffin oil group 1;there was significant difference in HR at T2,T3,T5,T6 between olbcaine group 2 and paraffin oil group 2(P<0.05),that is,at the time of tracheal intubation,tracheal intubation Compared with the paraffin oil group,the HR at T2,T3,T5 and T6 of the three groups were significantly different(P<0.05),that is,at the time of tracheal intubation,10 min after tracheal intubation,10 min after tracheal extubation,10 min after tracheal extubation and 10 min after tracheal extubation,the HR at T2,T3,T5 and T6 of the three groups were significantly different(P<0.05)Because the three groups were better than the three groups of paraffin oil.2.2.2 Comparison of HR among olbcaine groupsThe HR at T2,T3,T5 and T6 of group 1 and group 2 were significantly different(P<0.05),that is,the HR at T2,T3,T5 and T6 of group 2 was better than that of group 1 at tracheal intubation,10 min after tracheal intubation,tracheal extubation and 10 min after tracheal extubation;the HR at T2,T3,T5 and T6 of group 1 and group 3 was significantly higher than that of group 1 The differences were statistically significant(P<0.05),that is,at the time of tracheal intubation,10 min after tracheal intubation,tracheal extubation and 10 min after tracheal extubation,the three groups of obucaine were better than the one group of obucaine;the HR at T2,T3,T5 and T6 of the two groups and the three groups were statistically significant(P<0.05),that is,at the time of tracheal intubation 10 minutes after tracheal intubation,tracheal extubation and 10 minutes after tracheal extubation,olbcaine group 3 was better than olbcaine group 2.3.Comparison of VAS pain scoreThe results showed that there was no significant difference in VAS pain score between the six groups(P>0.05),and there was significant difference in VAS pain scores in one hour after operation and two hours after operation(P<0.05).3.1 Comparison of VAS pain scores between obuccain and paraffin oil groupsThere was no significant difference in VAS pain scores between obuccain 1 group and paraffin oil group 1 before operation,1 hour after operation and 2 hours after operation(P>0.05);the difference of VAS pain scores in obuccaine group 2 and paraffin oil group 1 and 2h after operation was statistically significant(P<0.05).That is,in the effect of reducing nasal and throat pain at 1 and 2 hours after operation,the effect of obvacaine 2 group was better than that of stone stone The difference of VAS pain scores in the two groups was statistically significant(P<0.05),that is,in the reduction of nasal and throat pain at 1 and 2 hours after operation,obuccain 3 group was better than paraffin oil group 3.3.2 Comparison of VAS pain scores among obuccine groupsThe difference of VAS pain scores in obuccain 1 group and obcaine group 2 was statistically significant(P<0.05).That is,in the aspect of reducing nasal and throat pain at 1 and 2 hours after operation,obuccain 2 group was better than obuccain 1 group;the difference of VAS pain score between obuccain 1 group and obuccain group 3 was statistically significant(P<0.05).The results showed that obuccain 3 group was better than obuccine 1 group in the reduction of nasal and throat pain at 1 hour and 2h after operation;the difference of VAS pain score between obuccain 2 group and obuccain group 1 hour after operation was statistically significant(P<0.05).That is,in the aspect of reducing the pain of nasal cavity and throat at 1 hour after operation,obuccain 3 group was better than that of obuccain 2 group.4.Comparison of other complicationsThe comparison of other complications between the six groups showed that there was a significant difference between the two groups(P<0.05).4.1 Comparison of complications between obuccain group and paraffin oil groupThere was no significant difference between the 1 groups of obuccain and paraffin oil in the 1 groups(P>0.05);there was no significant difference between the 2 groups of orb and paraffin oil 2 groups(P>0.05);there was no significant difference between the 3 groups of orb and paraffin oil 3 groups(P>0.05),that is,the same range of paraffin oil and Oxybuprocaine Hydrochloride Gel were applied in reducing other complications.There was no significant difference.4.2 Comparison of complications among groups of obuccainThere was no statistical significance between obuccain 1 group and obuccain group 2(P>0.05);the difference between obuccain 1 group and obuccain group 3 was statistically significant(P<0.05).That is,in reducing other complications,the difference between obuccain group 3 was better than that of obuccain 1 group;the difference between obuccain 2 group and obuccain group 3 was statistically significant(P<0.05),that is,in the group 2 and obuccain group 3.In terms of reducing other complications,obuccain group 3 was better than that of obuccain 2 group.ConclusionIn the treatment of oral cavity caries in preschool children under general anesthesia,the application of Oxybuprocaine Hydrochloride Gel at the front of the endotracheal tube is more conducive to maintaining stable hemodynamics during perioperative period than with smearing wax oil.It can also relieve the pain caused by endotracheal intubation and extubation.The smearing range of Oxybuprocaine Hydrochloride Gel in a range of endotracheal tubes is more than a certain range.The greater the effect,the more stable the hemodynamics during the perioperative period.At the same time,it can reduce the pain reaction caused by tracheal intubation and extubation,reduce the incidence of epistaxis,cough and hoarseness,and improve the postoperative comfort of children. |
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