静脉输入不同浓度利多卡因的药效学研究  

Pharmacodynamic Study of Computer Assisted Continuous Infusion of Lidocaine to Maintain a Constant Drug Concentration in Blood

作　　者：施冲[1,2] 梁炎基[1,2] 王若松 钱军[1,2] 王舟琪 刘桥义[1,2] 

机构地区：[1]广州军区广州总医院麻醉科 [2]重庆第三军医大学新桥医院麻醉科

出　　处：《临床麻醉学杂志》1997年第1期20-22,共3页Journal of Clinical Anesthesiology

摘　　要：本研究应用微机辅助输液泵（ＣＡＣＩ）装置持续静脉输入利多卡因维持恒定目标血药浓度（Ｃｔ），观察不同Ｃｔ利多卡因静脉复合麻醉的临床药效学。输入利多卡因的同时吸入一定浓度的安氟醚，测定安氟醚的ＭＡＣ，从而推算出静滴利多卡因的麻醉效能。结果表明，利多卡因Ｃｔ３μｇ／ｍｌ时可减少安氟醚ＭＡＣ１１．９％；Ｃｔ５μｇ／ｍｌ时减少２３．８％；Ｃｔ５μｇ／ｍｌ复合芬太尼（１～２μｇ／ｋｇ）减少４２．９％；Ｃｔ３μｇ／ｍｌ复合芬太尼（１～２μｇ／ｌｇ）减少２８．６％。上述各组的麻醉深度对血流动力学影响较小，所测得ＭＡＣ相当于ＭＡＣ－ＢＡＲ。结果提示利多卡因Ｃｔ３～５μｇ／ｍｌ复合小剂量芬太尼对循环影响小、临床麻醉效能高、苏醒彻底、苏醒期安静。应用ＣＡＣＩ输入利多卡因安全、可靠、值得推广应用。In order to study the application of computer assisted continous infusion(CACI) of lidocaine intravenously to maintain a constant target drug concentration (Ct)in the blood,the clinical pharmacodynamics of different lidocaine Ct complex intravenous anesthesia was observed.While lidocaine was infused intravenously,a certain concentration of enflurane was inhaled.The the MAC of enflurane was determined and the anesthetic effect of intravenously infused lidocaine was calculaced.It was found that lidocaine Ct 3μg/ml could reduce enflurane MAC by 11 9%;lidocaine Ct 5μg/ml by 23 8%,lidocaine Ct 3μg/ml supplemented with fentanyl 1 2μg/kg by 28 6%;and lidocaine Ct 5μg/kg supplemented with 1 2μg/kg fentanyl by 42 9%.The anesthetic depth of the 4 groups mentioned above had little effects on the hemodynamics recoery and the MAC measured was consistent with MAC BAR.These indicate that lidocaine Ct 3 5μg/ml supplemented with 1 2μg/kg fentanyl is an ideal complex intravenous anesthetic technique which exerts little effects on the circulation with potent clinical anesthetic effects,complete and quiet recovery.CACI of lidocaine is safe and reliable and it is recommended to be used clinically。

关 键 词：药效动力学 CACI 利多卡因 静脉麻醉 

分 类 号：R971.2[医药卫生—药品] R614.24[医药卫生—药学]