Effect Of Ultrasonic Aerosol Inhalation Of Low-dose Lidocaine On Cough Reaction Induced By Different Inducements

Objective:To explore whether ultrasonic aerosol inhalation of low-dose glucose and lidocaine administration on tube-induced coughing during anesthetic emergence in patients undergoing laparoscopic cholecystectomy through animal and clinical experiment.Methods:In animal experiments,20 7-weeks-old KM mice were randomly divided into two groups.The model of ALI was prepared by using ammonia to induce coughing.(1)control group:ultrasonic aerosol inhalation of 0.9%saline(10ml);(2)aerosol group:ultrasonic aerosol inhalation of 2%lidocaine(10 ml/kg);the number of coughs and the incubation period of coughing in the two groups of every mice within three minutes were recorded.During the clinical trial,a total of 90 cases of patients with ASA grade I~III and aged 20~60 yr and BMI 19~24 Kg/m~2 undergoing laparoscopic cholecystectomy under general anesthesia were randomly allocated to ultrasonic aerosol inhalation of 0.9%saline(group C,n=30)or lidocaine(group L,30),or glucose with lidocaine(group G/L,n=30).Aerosol inhalation by ultrasonic atomizer for release of moderate intensity at the time after surgery.L group ultrasonic aerosol inhalation of 2%lidocaine(0.1 ml/kg),group G/L ultrasonic aerosol inhalation of 2%lidocaine containing 4 mg/ml glucose(0.1 ml/kg).The control group ultrasonic aerosol inhalation of 0.9%saline.The mean arterial pressure(MAP)and heart rate(HR)were recorded respectively in the basal state(T0),in the time before extubation(T1),in the time instantly after extubation(T2),in the 1minute after extubation(T3)and in the 3 minutes after extubation(T4)and in the 5minutes after extubation(T5).The incidence of cough?struggle and nausea?emesis during extubation were recorded at the same time.Results:1.Animal experiment:the incubation period of cough in the aerosol group was significantly prolonged,and the times of coughing fit was significantly reduced(p<0.05);2.Clinical experiment:the incidence of struggle?cough and nausea?emesis during extubation were significantly reduced in the L group and the G/L group(p<0.05),and the fluctuations of MAP and HR during extubation were more stable than the C group(p<0.05),but there was no significant difference between the L group and G/L group(p>0.05).Conclusions:Ultrasonic aerosol inhalation of lidocaine can reduce the incidence of cough?struggle and nausea?emesis during general anesthesia recovery and extubation.However,aerosol inhalation of a small dose of sugary mix with lidocaine did not encourage a better outcome.