肾上腺素与利多卡因对开颅术患者血流动力学的影响  

Hemodynamics Responses to Epinephrine and Lidocaine in Craniotomy Patients

作　　者：孙燕[1] 张璟瑜[1] 李羽[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《华西医学》2012年第2期245-249,共5页West China Medical Journal

摘　　要：目的观察不同浓度肾上腺素与利多卡因混合液头皮浸润注射对开颅术患者血流动力学的影响。方法选取2010年5月-10月80例颅内肿瘤患者,随机分成4组,行1%利多卡因溶液混合不同浓度的肾上腺素16 mL头皮浸润注射。肾上腺素浓度:A组2.5μg/mL、B组5.0μg/mL、C组7.5μg/mL、D组10.0μg/mL。记录注射前(T0)、注射后5 min内(T1-10)心率(HR)、平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP),根据各时段的MAP最低值和最高值,计算MAP的降低率和升高率,计数各组MAP下降10%以内、10%～20%和20%以上的例数。结果 C组的MAP下降例数最多且MAP下降率最高,与其他组间比较差异有统计学意义(P<0.05)。组内比较,C组MAP、SBP在1.5、2.0、2.5 min时、DBP在2 min时和D组MAP和DBP在1.5、2.0 min时下降差异有统计学意义(P<0.05)。4组血压下降的同时伴HR增快,但HR组间差异无统计学意义(P>0.05)。结论低浓度的肾上腺素与10%利多卡因混合液用于开颅术患者头皮浸润注射时可导致血压下降。Objective To evaluate the hemodynamic changes induced by different concentration of epinephrinelidocaine solution during craniotomy.Methods Eighty patients accepted craniotomy between May and October 2010.They were randomly divided into four groups.Each group of patients were infiltrated with 16mL of 1% lidocaine solution and different concentrations of epinephrine.Group A accepted 2.5 μg/mL epinephrine,group B 5.0 μg/mL,group C 7.5 μg/mL,and group D 10.0 μg/mL.We recorded the heart rate（HR）,mean arterial pressure（MAP）,systolic pressure（SBP）,diastolic pressure（DBP） at the point of before using epinephrine（T0） and every 30 seconds in 5 min after using epinephrine（T1-10）.Based on the lowest and the highest MAP,the reducing and the rising rate of MAP were calculated.Moreover,we calculated the number of patients whose MAP decreased by less than 10%,between 10% and 20%,and beyond 20% on the basis of T0 in all groups.Results MAP falling rate and number of patients with decreased MAP in group C were significantly more than other groups.MAP and SBP falling at minute 1.5,2.0 and 2.5 after using epinephrine,DBP falling at minute 2.0 in group C,MAP and DBP falling at minute 1.5 and 2.0,were significantly different.The arterial pressure dropped with HR accelerating in all groups.However,HR had no significant difference among the groups.Conclusion Low concentration of epinephrine combined with lidocaine solution used for scalp infiltration can cause the patients’ arterial pressure to decrease in craniotomy.

关 键 词：肾上腺素/利多卡因混合液 开颅术头皮浸润法 血压流动力学 

分 类 号：R614[医药卫生—麻醉学]