INFORMATION : page. 275~281 / 2012 Vol.14 No.4
기관내 삽관은 마취 환자의 기도확보는 물론 흡입마취 유지에 필수적 요소로써 기관내관 및 기관삽관술의 발전은 마취기술을 발전시켜 수술소요시간이 길어지는 장기이식수술을 발전시키는 토대가 되었다. 1941년 Murphy가 현대적 개념의 기관내관을 고안하기 전까지는 도뇨관이나 직장관을 기관에 삽입하여 마취 환자의 기도를 확보하였다(Forestner, 2010). 이와 같이 흡입성 전신마취에는 후두경 및 기관내관의 삽입이 필수적이나 후두경 및 기관내관 삽입에 따른 고혈압, 빈맥, 부정맥과 같은 심혈관 불안정과 두개내압의 상승과 같은 합병증이 따르게 된다(Edwards, Alford, Dobson, Peacock, & Reilly, 1994; Kaplan & Schuster, 1991).
Purpose: This study was performed to evaluate the effect of low-dose lidocaine on fentanyl-induced cough and hemodynamic changes under general anesthesia. This research was a randomized trial design and performed using a double-blind method. Methods: Data collection was performed from October 22, 2008, to May 4, 2009. One hundred and thirty two patients were randomly assigned to control group (Con G) and experimental group (Exp G) using a table of random numbers. Exp G (n=66) were administered 0.5 mg/kg lidocaine and Con G (n=66)) were administered saline. The occurrence of cough and vital sign were recorded within one minute after fentanyl bolus by an anesthesiologist. Collected data were analyzed using Repeated measures ANOVA using SPSS for Windows (Version 17.0). Results: The incidence of cough in Exp G was 13.6%, while Con G was 53%. The incidence cough in Exp G was significantly lower compared to Con G (p<.001). Lidocaine seemed not to suppress mean arterial pressure (p=.145), heart rate (p=.508), and oxygen saturation (p=.161). Conclusion: Intravenous administration of 0.5 mg/kg lidocaine seems to suppress fentanyl-induced cough without affecting mean blood pressure, heart rate and oxygen saturation. Therefore, we recommend intravenous 0.5 mg/kg lidocaine administration to suppress fentanyl-induced cough under general anesthesia.
Cough,Fentanyl,Intra-operative care,Lidocaine,기침,펜타닐,마취환자 간호,리도카인