不同剂量利多卡因对罗库溴铵静脉注射痛及诱导期心血管反应的影响  

Effects of different doses of lidocaine on rocuronium induced injection pain and cardiovascular responses during anesthetic induction

作　　者：朱琳佳[1] 桂波[1] 倪燕[1] 朱莉莉[1] 钱燕宁[1] 

机构地区：[1]南京医科大学第一附属医院麻醉科,210029

出　　处：《临床麻醉学杂志》2013年第4期336-338,共3页Journal of Clinical Anesthesiology

摘　　要：目的比较不同剂量利多卡因对罗库溴铵静脉注射痛及诱导期心血管反应的影响。方法择期全麻手术气管插管患者120例,随机分为四组,分别预注利多卡因20mg(L1组)、40mg(L2组)、60mg(L3组)或生理盐水(C组),30s后静注罗库溴铵10mg。记录入室后10min(基础值)、诱导药物推注完毕后0、30、60、90、120s及插管后0、30、60s的MAP和HR。采用Chiarella评分标准评定注射痛。结果随着利多卡因剂量增加,患者注射痛程度明显减轻,L2、L3组重度以上疼痛患者明显少于L1组和C组(P<0.05或P<0.01),且无一例极重度疼痛。L3组仅有1例重度疼痛,明显优于L2组(P<0.05)。插管后0～60sL3组MAP明显低于C组和L1组(P<0.05),HR明显慢于C组和L1组(P<0.05)。结论预注利多卡因可减轻罗库溴铵注射痛,且与剂量相关。预注利多卡因60mg尚可抑制气管插管心血管反应。Objective To compare the effects of different doses of lidocaine on rocuroniuminduced injection pain and hemodynamic response during anesthesia induction. Methods A total of 120 patients scheduled for tracheal intubation were randomized into 4 groups： control group （group C）, 20 mg lidocaine （group L1）, 40 mg lidocaine （group L2） and 60 mg lidocaine （group L3） groups. After pretreatment with experimental drug by double blinded methods, 10mg of rocuronium was then administered 30 s later. The pain severity was scored and recorded according to the four-point scale of Chiareila. Hemodynamic parameters were then collected at baseline, 0, 30, 60, 90, 120 s following injection of all anesthetics, as well as 0, 30 s, 1 min after tracheal intubation. Results Injection pain was relieved with the dose of lidocaine. Compared with the group C or group L1, the number of patients with severe pain was lower and no patient had very severe pain in group L2 and group L3 （P 〈0. 05 or P〈0.01）. One patient had severe pain in group L3, which was better than group L2. MAP was lower and HR was slower in group L3 than in group C and L1 at 0-60 s after intubation （P〈0. 05）. Conclusion Pretreatment with lidocaine can relieve the injection pain induced by rocuronium dose-dependently. And pretreatment with 60 mg of lidocaine may suppress hemodynamic stress response to tracheal intubation.

关 键 词：利多卡因 罗库溴铵 静脉注射痛 气管插管 应激反应 

分 类 号：R614[医药卫生—麻醉学]