Pulmonary protective effect of nebulized inhalation of lidocaine on elderly patients undergoing hip fracture surgery
10.3760/cma.j.cn431274-20230129-00063
- VernacularTitle:雾化吸入利多卡因对老年髋部骨折手术患者的肺保护作用
- Author:
Wenkai WANG
1
;
Lufei DING
;
Wendan ZHOU
;
Junta YANG
;
Liping ZHOU
Author Information
1. 惠州市第六人民医院麻醉科，惠州 516211
- Keywords:
Lidocaine;
Administration, inhalation;
Hip fracture;
Lung protection
- From:
Journal of Chinese Physician
2023;25(11):1678-1681
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the lung protective effect of nebulized inhalation of lidocaine (NL) on elderly patients undergoing hip fracture surgery.Methods:A prospective study was conducted on 80 elderly patients who underwent hip fracture surgery at the Huizhou Sixth People′s Hospital from September 2020 to December 2021. They were randomly divided into an NL group and a control group with 40 patients in each group. Within 30 minutes before the start of anesthesia, the NL group was given 2% lidocaine 10 ml oxygen driven nebulization inhalation, while the control group was given equal volume sterile injection water nebulization inhalation. All patients underwent general anesthesia with laryngeal mask intubation and iliac fascia space block. A randomized, double-blind, and controlled clinical study was conducted. The average values of intraoperative peak airway pressure (P peak), plateau airway pressure (P plat), and lung dynamic compliance (C dyn) were compared between two groups of patients; We compared the changes in arterial partial pressure of CO 2 (PaCO 2), alveolar arterial oxygen differential pressure (A-aDO 2), respiratory index (RI), and oxygen index (OI) between the two groups of patients and before and after surgery; The clinical pulmonary infection score (CPIS) and lung ultrasound score (LUS) were also compared between two groups of patients on the first day before surgery, the second day after surgery, and the seventh day after surgery. Resultsl:There was no statistically significant difference in the average values of P peak, P plat, and C dyn between the two groups during surgery (all P>0.05). After surgery, A-aDO 2 and RI in both groups increased compared to before surgery, while OI decreased compared to before surgery (all P<0.05); After surgery, A-aDO 2 and RI in the NL group decreased compared to the control group, while OI increased compared to the control group (all P<0.05); There was no statistically significant difference in PaCO 2 between the two groups before and after skin incision (all P>0.05). Compared with the 1st day before surgery, the CPIS and LUS in both groups were significantly increased on the 2nd and 7th day after surgery (all P<0.05); Compared with the second day after surgery, the CPIS and LUS of both groups of patients were significantly reduced on the seventh day after surgery (all P<0.05); On the second day after surgery, the CPIS and LUS in the NL group were significantly lower than those in the control group (all P<0.05); On the 7th day after surgery, the LUS of the NL group was significantly lower than that of the control group ( P<0.05); There was no statistically significant difference in CPIS scores between the two groups ( P>0.05). Conclusions:Nebulized inhalation of lidocaine can reduce lung function damage in elderly patients undergoing hip fracture surgery, and has a certain lung protective effect.
