利多卡因减轻老年高血压病人ERCP手术中的心血管应激  

Effects of Lidocaine on Cardiovascular Responses of Endoscopic Retrograde Cholangio Pancreatography in Elderly patients with Hypertension

作　　者：谢宇颖[1] 汤泓[2] 王勇 王颖[1] 岳子勇[4] 戚思华[1] 隋红[5] 

机构地区：[1]哈尔滨医科大学第四临床医学院,黑龙江哈尔滨150001 [2]黑龙江省医院,黑龙江哈尔滨150030 [3]哈尔滨市第七医院,黑龙江哈尔滨150050 [4]哈尔滨医科大学第二临床医学院,黑龙江哈尔滨150081 [5]哈尔滨医科大学,黑龙江哈尔滨150081

出　　处：《现代生物医学进展》2014年第12期2282-2285,共4页Progress in Modern Biomedicine

基　　金：黑龙江省教育厅科学技术研究面上项目(11551264)

摘　　要：目的：观察静脉给予利多卡因在ERCP手术中对老年高血压患者心血管应激反应的影响,观察该方法对静脉麻醉药丙泊酚用量的影响。方法：选择80例行ERCP手术的老年高血压患者,随机分为A组和B组。A组患者先给予1μg/kg的芬太尼随后再以2～3mg/sec的速度注入丙泊酚;B组患者先给予1.5mg/kg利多卡因随后再以2～3mg/sec的速度注入丙泊酚。待患者达到Ramsay 5级时开始进行ERCP检查。记录诱导前、诱导后、进镜、术中、退镜及苏醒时的血压、心率、呼吸频率及脉搏氧饱和度,并记录术中丙泊酚维持剂量及不良反应,包括呼吸暂停、呛咳、呃逆、体动的发生率。结果：两组患者基本情况无统计学差异。A组、B组患者在诱导后收缩压和舒张压明显低于诱导前。A组收缩压和舒张压在诱导后、进镜、术中、退镜时显著低于B组;A组呼吸频率在诱导后低于B组。B组不良反应发生率显著低于A组。B组丙泊酚用量明显少于A组（P〈0.05）。B组苏醒时间短于A组。结论：利多卡因复合丙泊酚应用于老年患者,麻醉效果好、血流动力学稳定,术中丙泊酚用量少,术后苏醒迅速值得在临床推广。Objective：In the present study,effects of lidocaine on cardiovascular responses were observed in elderly hypertension patients during endoscopic retrograde cholangio pancreatography.Methods：Eighty patients scheduled for were randomly scheduled for endoscopic retrograde cholangio pancreatography were randomly divided into group A and B.All patients were given fentanyl 1 μg/kg and propofol 2～3 mg/sec intravenously in Group A.All patients were given lidocaine 1.0 mg/kg and propofol 2～3mg/sec intravenously in Group B.When RSS was reached 5 degrees,endoscopy intubation were performed.SBP,DBP,HR,SpO2and bispectral index（BIS） were recorded before and after anesthesia induction,start-endoscope,intra-operation,finish-endoscopy,and revival.Complications and propofol in intraoperation were also investigated.Results：There were no significant differences in the basic statements between group A and B.SBP and DBP decreased significantly after induction in both groups compared with the baseline value（P〈0.05）.SBP and DBP in Group A were decreased significantly after anesthesia induction,start-endoscope,intra-operation and finish-endoscopy than Group B.Total dose of propofol are lower in group B compared with group A（P〈0.05）.Conclusions：We conclude that the i.v.administration of lidocaine attenuates the hemodynamic instability and total dose of propofol and,it does not increase side effects in endoscopic retrograde cholangio pancreatography procedure in elderly patients with hypertension.

关 键 词：利多卡因 丙泊酚 老年 高血压 

分 类 号：R614.24[医药卫生—麻醉学] R544.1[医药卫生—外科学]