不同浓度利多卡因局部浸润麻醉在腹股沟疝修补术中的应用  

Application of low concentration of lidocaine for inguinal hernia repair under local infiltration anesthesia

作　　者：宋应寒[1] 陆安清[1] 马东扬[1] 白佳[2] 雷文章[1] 

机构地区：[1]四川大学华西医院胃肠外科疝中心,成都610041 [2]四川大学华西医院中西医结合科,成都610041

出　　处：《中华疝和腹壁外科杂志（电子版）》2013年第6期16-18,37,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的比较0.25%和0.5%浓度的利多卡因局部浸润麻醉在成人腹股沟疝修补术中的麻醉效果。方法 2012年10月至2012年12月四川大学华西医院收治成人单侧腹股沟疝患者100例,随机分为观察组和对照组各50例,观察组给予0.25%利多卡因,对照组给予0.5%利多卡因行局部浸润麻醉下无张力疝修补术。记录术中使用的利多卡因的体积、剂量、手术时间和麻醉相关并发症,评估患者切皮时、手术开始10 min和手术结束时的视觉模拟评分(visual analogue scale,VAS)及患者对麻醉的满意度。结果本组患者均无更改麻醉方式。二组术中使用利多卡因的剂量[(153±30)mg vs(287±36)mg]比较差异有统计学意义(F=404.629,P=0.000),其他各项指标二组之间比较差异均无统计学意义。结论不同浓度利多卡因局部浸润麻醉用于腹股沟疝无张力修补获得了相同的麻醉效果,但在麻醉药物剂量方面0.25%组明显低于0.5%组。应用低浓度利多卡因可降低局部麻醉药不良反应的危险性,值得推荐。Objective To compare the anesthetic effect of 0.25% with 0.33% lidocaine for inguinal hernia repair under local infdtration anesthesia. Methods One hundred adult patients with single-side inguinal hernia were randomized into two groups and performed with tension free mesh hernia repair under local infdtration anesthesia with 0.25% （ the observation group） and 0.5% （ the control group） lidocaine. The volume and doses of lidocaine used, duration of surgery, and anesthesia-related complications were strictly recorded. The visual analogue scale （VAS） scores at the beginning of surgery, ten minutes later and at the end of the surgery were obtained, as well as the degree of satisfaction of the patients. Results Mean doses of lidocaine consumed were significantly lower in the observation group than the control group （ 153± 30 mg vs. 287 ±36 mg,F=404. 629,P =0.000） ; other parameters were comparable between two groups. Conclusions Either of the two concentrations of lidoeaine provided satisfactory anesthetic effects, hut the observation group consumed lower doses of lidocaine and thus may lead to a lower risk of local anesthetic adverse reaction. 0. 25% lidocaine is recommended for inguinal hernia repair under local infiltration anesthesia.

关 键 词：疝 腹股沟 麻醉 局部 利多卡因 

分 类 号：R614[医药卫生—麻醉学]