静脉注射利多卡因对结直肠切除手术的影响  

Effects of intravenous infusion of lidocaine on colorectal resection

作　　者：邹毅清[1] 聂海贵[1] 魏斌[1] 曾淑珍[1] 李小宝[1] 杨志星[1] 

机构地区：[1]南京军区福州总医院四七六医院麻醉科,350002

出　　处：《中国医师进修杂志》2010年第6期31-33,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨静脉注射利多卡因对结直肠切除手术的影响。方法将60例择期行结直肠切除手术患者按随机数字表法分为两组，L组为利多卡因组，诱导期前静脉注射1％利多卡因1．5mg／kg，随后以1．5mg／（kg·h）的速度持续静脉输注至术后12h；C组为0．9％氯化钠对照组，输注同量的0．9％氯化钠。记录术后疼痛视觉模拟量表（VAS）评分、吗啡的用量及术后肛门排气和第1次排便时间。结果L组维持血流动力学稳定的呼气末七氟烷浓度明显低于C组（P〈0．05）。L组术中舒芬太尼用量为（17．5±3．8）μg，C组为（25．6±4．5）μg，两组比较差异有统计学意义（P〈0．05）。L组术后肛门排气时间、第1次排便时间 及术后24、48h吗啡用量[（23±6）h、（31±7）h、（32±6）mg、（58±7）mg]均低于C组[（28±7）h、（43±9）h、（46±8）mg、（71±10）mg]（P〈0．05）。术后各时间点静息VAS评分两组比较差异无统计学意义；但活动和咳嗽时VAS评分L组低于C组（P〈0．05）。结论围手术期静脉注射小剂量利多卡因有利于结直肠切除手术后的康复。Objective To investigate the effects of intravenous infusion of lidocaine on colorectal resection. Methods Sixty patients undergoing eolorectal resection were randomly divided into group L [receiving intravenous infusion of 1% lidocaine, bolus injection of 1.5 mg/kg lidocaine at induction of anesthesia, followed by a continuous infusion of 1.5 mg/（kg·h ） intraoperatively and for 12 h postoperatively ] and group C （an equal volume of saline ）. Postoperative pain scores （VAS score） and morphine consumption were measured. Times of flatus and first defecation were recorded. Results The end expiration sevoflurane concentration maintaining hemodynamics stable in group L was lower than that in group C （P 〈 0.05 ）. The dose of sulfeutanyl was （17.5 ± 3.8） μg in group L, （25.6 ± 4.5） μg in group C, there was significant difference between two groups （P 〈 0.05 ）. The times of flatus first, defecation and morphine consumption at 24 and 48 h after operation in group L were lower than those in group C [ （23 ± 6 ） h vs （28 ± 7 ） h, （ 31 ± 7 ） hvs（43±9） h, （32±6） mgvs （46±8） mgand （58±7） mgvs （71 ±10） mg , P 〈 0.05 ]. There was no significant difference at resting VAS score, but there was significant difference at movement and cough VAS score between two groups （P 〈 0.05 ）. Conclusion Perioperative administration of low doses of intravenous infusion of lidocaine reduces iutraoperative anesthetic requirements and has a clinically relevant beneficial effect on postoperative recovery after colorectal resection.

关 键 词：利多卡因 结直肠外科手术 手术后恢复 

分 类 号：R752.53[医药卫生—皮肤病学与性病学] R739.4[医药卫生—临床医学]