利多卡因持续静脉泵注对鼻内窥镜术中异氟醚用量及术后疼痛的影响  

Effects of intravenous infusion of lidocaine on isoflurane consumption and postoperative pain in patients underwent nasal endoscopy surgery

作　　者：于淑侠[1,2] 马正良[1] 顾小萍[1] 王尔华[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008 [2]南京市中西医结合医院

出　　处：《临床麻醉学杂志》2010年第6期494-496,共3页Journal of Clinical Anesthesiology

基　　金：南京市卫生局重大课题(2kx08028)

摘　　要：目的观察术中持续静脉泵注利多卡因对鼻内窥镜术术中异氟醚用量及术后短期内疼痛的影响。方法 40例择期鼻内窥镜术患者随机均分为利多卡因组（L组）和对照组（C组）。L组麻醉诱导前缓慢静注利多卡因1 mg/kg,给予2 mg.kg^-1.h^-1泵注至手术结束;C组以生理盐水替代。两组均行丙泊酚、雷米芬太尼、阿曲库铵和异氟醚吸入复合全麻。调整异氟醚的吸入浓度,保持BIS值45-55。观察并记录入室后诱导前、诱导后、插管后1、5 min、拔管前5 min、拔管时、拔管后5、30 min、术后2、6 h的血压、心率;术中异氟醚用量;拔除气管导管前后行躁动评分;PACU期间需芬太尼镇痛例数及拔管后30 min、术后2、6 h VAS。结果两组术中血压、心率基本平稳。L组较C组术中异氟醚用量明显减少、PACU期间芬太尼用量减少、拔管时间缩短,术后2、6h VAS明显降低（P〈0.05）。结论术中静脉持续泵注利多卡因在鼻内窥镜术中能减少异氟醚用量,减轻术后疼痛。Objective To investigate the effects of intravenous infusion of lidocaine on isoflurane consumption and postoperative pain in patients underwent nasal endoscopy surgery.Methods Forty patients of selective nasal endoscopy surgery were divided randomely into two groups of L and C.Anesthesia was induced with propofol-remifentanil-atracurium and maintained with isoflurane inhalation,which was regulated to keep bispectral index（BIS） within 45-55.Before induction,group L was given lidocaine injection of 1.5 mg/kg,which was followed by lidocaine infusion of 2 mg·kg-1·h-1 intraoperatively.Group C received normal saline instead of lidocaine as the control.BP,HR,isoflurane consumption,time of extubation,VAS pain score and fentanyl injection were recorded during operation and at 0.5,2 and 6 h after surgery.Results BP and HR of two groups were stable.The isoflurane consumption was less,the time of extubation was earlier,VAS scores were less,and fentanyl injection in PACU was less in group L than those in group C（P〈0.05）.Conclusion Lidocaine used during operation could enhance anestheic depth and reduce postoperative pain in the patients undergoing nasal endoscopy surgery.

关 键 词：利多卡因 术后疼痛 鼻内窥镜术 

分 类 号：R614[医药卫生—麻醉学]