An observation on effect and safety of application of dyclonine in orotracheal intubation / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the efficacy and safety of dyclonine hydrochloride mucilage applied as a lubricant for orotracheal intubation. Methods A prospective study was conducted,144 patients with respiratory failure(RF)and clear consciousness admitted into Emergency Department of Xingtai People's Hospital in December 2010 to June 2013 for orotracheal intubation were randomly divided into experimental and control groups(each, 72 cases). Topical spray anesthesia onto the throat wall was applied for all the patients before orotracheal intubation. In the experimental group,the patients received 1%hydrochloric acid dyclonine mucilage as a lubricant,while in the control group,they received paraffin oil as a lubricant before the insertion of tracheal tube. The operating procedure of the insertion was in accord to the rules of orotracheal intubation in both groups. The changes of heart rate,systolic blood pressure,diastolic blood pressure,pulse oxygen saturation(SpO2),success rate of once tracheal intubation,incidence of choking cough,the time of tracheal intubation and dyclonine adverse reactions were observed. Results The heart rate,systolic and diastolic blood pressures were significantly higher and SpO2 was obviously lower after the intubation in both groups than those before the procedure,and the changes were more significant in the control group〔heart rate(bpm)135.2±9.9 vs. 98.1±8.1,systolic blood pressure(mmHg,1 mmHg=0.133 kPa)145.6±20.8 vs. 138.8±22.1,diastolic blood pressure(mmHg)96.1±17.6 vs. 82.9±22.8,SpO20.643±0.128 vs. 0.749±0.102, all P<0.05〕;the success rate of once tracheal intubation in experimental group was significantly higher than that in the control group〔98.6%(71 cases)vs. 84.7%(61 cases),P<0.01〕,the incidence of choking cough was obviously lower than that in the control group〔36.1%(26 cases)vs. 52.8%(38 cases),P<0.05〕,the time for insertion of tracheal tube in experimental group was also significantly shorter than that of control group(minutes1.9±0.9 vs. 2.3±1.1,P<0.05). No drug adverse reactions occurred. Conclusion Compared with paraffin oil,dyclonine hydrochloride mucilage as a lubricant for tracheal intubation is a simpler and easier operation which has the advantages of having better anesthesia,effectively reducing the irritation of the throat wall,improving the success rate of intubation,being more tolerable by the patients,reducing the adverse reaction rate during insertion of tube and having no occurrence of drug adverse reactions,therefore dyclonine can be applied in tracheal intubation.