Effect Of Lidocaine Combined With Ketorolac Tromethamine On The Periextubation Period Of Thyroid Surgery In Hypertensive Patients

Objective: To investigate the effects of different interventions on periextubation adverse reactions in hypertensive patients undergoing thyroid surgery.Methods:A total of80 hypertensive patients who underwent thyroid surgery was divided into four groups(n=20),the ketorolac group(K),the lidocaine group(L),the lidocaine combined ketorolac tromethamine group(LK)and the control group(C).The K group was given 30 mg ketorolac tromethamine before tumor resection and normal saline at the end of surgery.The L group was given normal saline before tumor removal and lidocaine 1.5 mg/kg at the end of surgery.The LK group was given 30 mg of ketorolac tromethamine intravenously before mass resection and 1.5 mg/kg of lidocaine at the end of surgery.The C group was given equal amount of normal saline before tumor resection and at the end of surgery.The extubation time and cough score when extubation were recorded.Recorded the mean arterial pressure and heart rate before anesthesia induction(T1),immediately after extubation(T2),5 min(T3),15 min(T4),30 min(T5)after extubation.Recorded the VAS scores of 5 min(T3),15 min(T4),30 min(T5),6h(T6),12 h(T7),24 h(T8)after extubation.Recorded the adverse effects after extubation and drainage of 24 h(T8)after surgery.Results: 1.Comparison of general condition: There was no significant differences in general condition between the four groups(P>0.05).2.Extubation time:There was no significant difference between the four groups(P> 0.05)。3.Cough score during extubation: the cough score during extubation in the L group and the LK group was lower than that in the C and K group(P<0.05).4.Hemodynamic comparison: MAP at T2 increased than MAP at T1 in the K group(P <0.05),and there was no significant difference between MAP at T3-T5 and T1(P <0.05).MAP in the C group at T2-T5 was higher than MAP at the same time points in the other three groups,significant(P <0.05).HR at T2,T3 and T4 in the C and K group increased compared with T1(P <0.05).There was no significant difference in HR at T2-T5 between the LK and L group and at T1 in the same group(P> 0.05).The HR at T2-T4 in both the L and LK group was lower than the HR at the same time point in group C(P <0.05).5.Comparison of VAS scores after extubation:The VAS scores of the K,L and LK group at T3-T6 were less than the VAS scores of the C group at the same time(P <0.05).The VAS scores at T6 and T7 in the K and LK group were smaller than those in the C and L group 6.Awakening quality and postoperative recovery: There was no significant difference in the incidence of adverse reactions after extubation between the four groups(P>0.05).The drainage rate of T8 in the L and LK group was smaller than that of the C and K group(P<0.05).Conclusion:Lidocaine combined with ketorolac can effectively reduce adverse reactions such as sore throat,circulatory fluctuation and wound bleeding after extubation in patients with hypertension,and help to improve the safety of such patients during extubation.