Abstract：Objective To observe the topical anesthesia effect of dyclonine hydrochloride mucilage used in slow induction intubation during digestive endoscopic surgery among outpatients.Methods Between August 2019 and December 2019, 70 patients who received surgical treatment under general anesthesia with endotracheal intubation in the Digestive Endoscope Center of the First Medical Center of the Chinese PLA General Hospital were randomly divided into two groups: 35 cases in the oral dyclonine hydrochloride mucilage group (the dyclonine group) and 35 cases in the tetracaine spray group (the tetracaine group). Peroral endoscopic myotomy (POEM) and endoscopic submucosal dissection (ESD) were adopted. The induction method of general anesthesia was amnesia, analgesia and wakening, and slow induction of endotracheal intubation. The dyclonine group was given dyclonine hydrochloride mucilage (0.1 g/10 ml) for oral topical anesthesia, while the tetracaine group received 1% tetracaine spray for topical anesthesia, with the total amount no more than 2 ml. The changes of blood pressure and heart rate at six different time points were observed and recorded. The scores of numbness in the oropharynx before endotracheal intubation, the duration (s) and frequency of intubation, the incidence of cough and sore throat during extubation, and the severity of throat pain at 24 h and 48 h after endotracheal intubation were recorded using the VAS score.Results There was no significant difference in the basic data and duration of surgery between the two groups. MAP of the dyclonine group immediately after intubation (T2), 5 min after intubation (T3), 3 min after left lateral positioning (T4) and immediately after extubation (T5) was significantly lower than that of the tetracaine group. There was no significant difference in HR between the two groups at different time points. The duration of intubation in the dyclonine group was shorter than that of the tetracaine group [(18.37±2.78)s vs. (22.49±6.62)s, P<0.01], but there was no significant difference in levels of oropharyngeal numbness between the two groups. The incidence of cough and sore throat in the dyclonine group (20.0%, 5.7%) was lower than in the tetracaine group (69.6%, 42.9%, P<0.01) . The score of sore throat in the tetracaine group (0.66±1.33) was lower than that of the tetracaine group (2.09±1.87) at 24 hours postoperatively (P<0.01), but there was no significant difference between the two groups at 48 hours after operation.Conclusions Dyclonine hydrochloride mucilage can deliver good oropharyngeal topical anesthesia effect when used in awake and slow induction with endotracheal intubation during digestive endoscopic surgery. Compared with tetracaine spray, the hemodynamics of patients is more stable. Dyclonine hydrochloride mucilage has many advantages over tetracaine spray in outpatient surgery.
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