[Effection of combining dexmedetomidine with lidocaine cream on response to tracheal extubation in pediatric tonsillectomy].

Objective: To evaluate the effects of combining dexmedetomidine with lidocaine cream on extubation reaction in pediatric tonsillectomy. Methods: Eighty children scheduled for tonsillectomy from January to June 2016 in the Lanzhou University Second Hospital, were randomly divided into group C (controll group), group D (dexmedetomidine group), group L (lidocaine cream group)and group R (combing dexmedetomidine with lidocaine group) by digital random table method ( n =20). In group D and R, dexmedetomidine 1 μg/kg was injected intravenously after general anesthesia induction, and the same volume of normal saline was given in group L and C. Meanwhile, the children in group L and R were intubated with endotracheal tube coated with compound lidocaine cream at first third, while the children were intubated with endotracheal tube coated with liquid paraffin in group D and C. Heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP) and saturation of pulse oximetry(SPO(2)) were recorded at the time of baseline(T0), before(T1) and immediately (T2) extubation, 1(T3), 5(T4), 10(T5)minutes after extubation. The time of spontaneous breathing recovery and extubation were recorded. Cough score, agitation score and adverse reactions were evaluated during the peri-extubation period. Results: During extubation, HR were (86.70±6.53), (89.30±4.93), (86.00±4.05) beats per minute at T1, T2, T3 respectively in group D, and they were (90.35±6.60), (91.20±6.44), (90.20±5.43) beats per minute in group L and were (85.70±8.67), (88.10±8.75), (86.95±7.73) beats per minute in group R. HR were (96.15±10.16), (97.75±10.93), (94.35±7.26) beats per minute at T1, T2, T3 respectively in group C. HR were significantly lower in group D, R and L than that in group C at T1, T2, T3( F =6.754, 5.655, 7.191, all P <0.05). Cough score were (1.80±0.70), (1.55±0.69), (1.25±0.44) in group D, L and R respectively. All of them were significantly lower than that in group C(2.45±1.05) ( F =0.614, P <0.05). Cough score were significantly lower in group R than that in group D( P <0.05). Agitation score were (1.95±0.83), (1.75±0.72) in group D and R respectively, and they were significantly lower than that in group C(2.90±1.21)( F =9.245, P <0.05). Agitation incidence were 20%, 15% respectively in group D and R, and they were significantly lower than that in group C(60%) (χ(2)=21.554, P <0.05). Conclusion: Combining dexmedetomidine with lidocaine cream can effectively alleviate stress and cough reaction during extubation in pediatric tonsillectomy.