利多卡因持续静脉注入对瑞芬太尼麻醉后痛觉评分的影响  

Effect of intravenous lidocaine infusion on pain scores after remifentanil anesthesia

作　　者：邱晓东[1] 陆新健[1] 杨琴华[1] 

机构地区：[1]东南大学附属中大医院麻醉科,江苏南京210009

出　　处：《现代医学》2010年第4期403-405,共3页Modern Medical Journal

摘　　要：目的:探索术中持续静脉注入利多卡因对瑞芬太尼麻醉后痛觉评分的影响。方法:选择ASA分级Ⅰ-Ⅱ级拟在全麻下行腹腔镜辅助妇科手术及腹腔镜胆囊切除术(LC)病人80例,随机分为瑞芬太尼复合利多卡因组(R+L组,n=40)和瑞芬太尼组(R组,n=40)。两组基本麻醉诱导和维持方案相同,仅R+L组麻醉诱导含利多卡因1mg·kg-1和麻醉维持含利多卡因2mg·min-1。病人清醒后拔管,分别于拔管后5、10、20、30、60min行疼痛视觉模拟评分(VAS),30min后如果VAS超过5分,给予舒芬太尼5μg·次-1,将VAS降至5分以下。记录各组手术时间、瑞芬太尼用量、复苏室内舒芬太尼的用量。结果:两组病人的手术时间、术中瑞芬太尼用量均无统计学差异(P>0.05)。拔管后5、10、20、30minR+L组的VAS均显著低于R组(P<0.05),拔管后60min两组的VAS无统计学差异(P>0.05)。在复苏室内的舒芬太尼用量,R+L组明显低于R组(P<0.05)。结论:术中持续静脉注入利多卡因可明显降低瑞芬太尼麻醉后的痛觉评分,减少复苏室内舒芬太尼的用量。Objective：To investigate the effect of intravenous lidocaine infusion on pain scores after remifentanil anesthesia.Methods：Eighty ASA Ⅰ or Ⅱ patients undergoing laparoscopy-assisted gynecological operation or laparoscopic cholecystectomy（LC） in general anesthesia were randomly divided into two groups：remifentanil combined lidocaine group（group R ＋ L,n = 40） and remifentanil group（group R,n = 40）.In group R,induction applied with propofol 1 mg·kg-1,sufentanil 0.4 μg·kg-1,vecuronium 0.1 mg·kg-1 intravenous injection,inhaling sevofluane for anesthesia maintaining,adjusting Remi＇s infusion according to blood pressure.In group R ＋ L,the same induction as group R except lidocaine 1 mg·kg-1 bolus and then 2 mg·min-1 intravenous injection during operation.Sevoflurane was ceased inhalation after pneumoperitoneum ended.Remifentanil and lidocaine infusion were stopped at the end of surgery.Postoperative pain was evaluated by visual analog score（VAS） at 5,10,20,30,60 min after extubation.If VAS exceeded 5 in 30 min after extubation,bolus sufentanil 5 μg to decrease VAS 5.Operation duration time,dose of remifentanil and sufentanil used during operation were recorded.Results：There was no significant difference in operation duration time and remifentanil consumption between two groups（P 0.05）.VAS was significantly lower in group R ＋ L than in group R at 5,10,20,30 min after extubation（P 0.05）,but there was no significant difference between two groups at 60 min after extubation.The consumption of sufentanil in postanesthesia care unit（PACU） was significantly less in group R ＋ L than in group R.Conclusion：Intravenous lidocaine infusion during operation can lower the postoperative pain scores and decrease the consumption of sufentanil in PACU.

关 键 词：麻醉 利多卡因 瑞芬太尼 疼痛视觉模拟评分 

分 类 号：R614.24[医药卫生—麻醉学]