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Objective To investigate the effect of laryngeal and endotracheal surface anesthesia on cough reflex during extubation after excision of supratentorial tumors, and observe its safety. Methods Forty patients were recruited in present study who underwent supratentorial tumor resection under general anesthesia in the Department of Neurosurgery, Peking University International Hospital from March 2021 to March 2022. The patients were randomly divided into tetracaine group (n=20) and control group (n=20). Patients in tetracaine group were uniformly sprayed 2 ml of 2% tetracaine on the bilateral vocal cords, epiglottis and trachea with an atomized laryngeal anesthetic tube before intubation, and patients in control group received no such treatment Anesthesia management was the same in the both groups. Cough score during extubation, NRS score for throat pain after extubation, NRS score for incision pain, mean arterial pressure (MAP) and heart rate were recorded at 3 min after arterial intubation (T0), before tracheal intubation (T1), 30 s after pulling the cuff after intubation (T2), and when the patient is conscious enough to pull out the tracheal intubation (T3), and the occurrence of hoarseness, swallowing and coughing after extubation. Results Five patients in each group were excluded. The cough score was significantly lower in tetracaine group than in control group (0.4±0.6 vs. 2.6±0.5). Their difference was –2.2 (95%CI –2.5, –1.9), lower than the valid assumed value –1.8. NRS score of throat pain in tetracaine group was significantly lower than control group after extubation [2(0, 2) vs. 4(3, 4.5), P<0.001]. However, no statistically significant difference existed between the two groups in NRS scores of incision pain [3(2, 3) vs. 3(2.5, 3.5), P=0.705]. The MAP was significantly lower in tetracaine group than in control group at T3 [(90.87±13.37) mmHg vs. (102.8±11.52) mmHg, P=0.014]; At T0-T3, there was no significant difference in heart rate between the two groups (P>0.05). No side effects such as hoarseness, swallowing and coughing occurred in both groups after operation. Conclusion Before tracheal intubation in patients undergoing supratentorial tumor resection, laryngeal and endotracheal surface anesthesia with 2% tetracaine could reduce the degree of choking during extubation, relieve pharyngeal pain after extubation, the blood pressure was more stable and no serious adverse reaction was found.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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