静脉输注利多卡因对结直肠切除手术炎症反应的影响  

Effects of intravenous infusion of lidocaine on inflammatory reaction in colorectal resection

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

机构地区：[1]南京军区福州总医院476医院,福建福州350002

出　　处：《现代中西医结合杂志》2010年第34期4392-4393,4396,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨静脉输注利多卡因对结直肠切除手术炎症反应的影响。方法将48例择期行结直肠切除手术患者随机分为2组:L组诱导期静脉注射利多卡因1.5 mg/kg,随后以1.5 mg/(kg.h)持续静脉输注至手术后12 h;C组输注同量的生理盐水。2组分别于诱导前、切口缝合完毕、手术后6 h、手术后3 d采血测IL-1β、IL-6、IL-8、IL-10和TNF-α。记录手术后视觉模拟疼痛量表评分及吗啡的用量。结果手术结束至术后3 d,L组IL-6、IL-8水平明显低于C组(P均<0.05),而TNF-α、IL-1β和IL-10水平无明显变化;L组手术后主动运动和咳嗽时的疼痛评分明显低于C组(P均<0.05),手术后吗啡的用量少于C组(P<0.05)。结论围手术期静脉注射小剂量利多卡因可减弱结直肠切除手术所致的过度炎症反应,有利于手术后的康复。Objective It is to explore the effects of intravenous infusion of lidocaine on inflammatory reaction in colorectal resection.Methods Forty eight patients scheduled to undergo colorectal resection were randomly divided into group L（receiving intravenous 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） or group C（receiving an equal volume of saline）.Plasma levels of IL-1β,IL-6,IL-8,IL-10 and TNF-α were gotten and determined before induction,after cut suture,in 6h and 3d after operation.Postoperative pain scores and morphine consumption were recorded.Results The levels of IL-6 and IL-8 in group L were significantly lower than that in group C from the end of operation to 3 d after operation,but there was no significant difference in plasma levels of TNF-α,IL-1β and IL-10 between the two groups.Postoperative pain scores when active exercise and cough was lower and used dosage of morphine was less in group L than that in group C.Conclusion Perioperative administration of low doses of intravenous lidocaine can reduce over inflammatory reaction and has a clinically relevant beneficial effect on recovery after operation.

关 键 词：利多卡因 炎症反应 结直肠切除术 镇痛 

分 类 号：R614[医药卫生—麻醉学]