碳酸利多卡因硬膜外持续输注给药麻醉方案的临床研究  

CLINICAL STUDY ON ADMINISTRATION SCHEDULE OF CONTINUED EPIDURAL INFUSION OF LIDOCAINE CARBONATE IN PATIENTS DURING EPIDURAL ANAESTHESIA

作　　者：张沂[1] 金志强[1] 吕立波[1] 鲍燕燕[1] 柯海 刘保平 

机构地区：[1]海军总医院 [2]武警北京第二医院

出　　处：《解放军医学杂志》2001年第10期778-779,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：通过临床手术麻醉 ,评价碳酸利多卡因在硬膜外麻醉中持续输注给药方案的安全性和有效性。采用利多卡因硬膜外麻醉常规剂量加持续输注给药方案 ,对 5 1例下腹部或下肢手术病人 ,观察其临床麻醉效果、血压、心律、心率及连续监测利多卡因血药浓度。结果 5 1例病人麻醉效果基本满意 ,除 1例出现心律失常外 ,余病人的血压、心律、心率均正常 ,无明显不良反应发生。 5 1例病人手术过程中共取标本 146份 ,平均 (2 9± 0 5 )份。利多卡因血药浓度为 (3 2 2± 1 48) μg /ml,范围 0 92～ 9 90 μg/ml。其中 5 0 7%标本血药浓度在理论计算值范围内 ,81 5 %在安全有效浓度内。结果表明 ,用此方法给药 ,可获得临床满意的麻醉效果 ,且无明显不良反应发生 ,大部分标本的血药浓度是在安全有效浓度范围内。To evaluate safety and efficacy of administration schedule of continuous epidural infusion of lidocaine carbonate in patients during epidural anaesthesia by clinical study.During epidural anaesthesia,an administration schedule of conventional dosage plus continuous epidural infusion was performed.Anaesthetic efficacy,blood pressure,heart rate and serum lidocaine concentrations of 51 patients undergoing lower abdominal and lower extremity operation using above administration schedule were monitored continuously during surgical operation.The results showed that anaesthetic efficacy of 51 patients was satisfactory,the blood pressure and heart rate of the patients except one patient were normal, and no adverse drug reaction took place during surgical operation.146 blood samples of 51 patients were obtained,mean sample number per patient was (2 9±0 5),mean lidocaine serum concentrations were (3 22±1 48)μg/ml.Serum lidocaine concentrations of 74 samples in 146 samples(50 7%) were within theoretical calculated concentrations. Among them,146 samples(50 7%) were within theoretical calculated concentration range.Serum lidocaine concentrations of 119 out of 146 samples were within range of safety and effectiveness as reported in literature. Serum lidocaine concentrations of 27 out of 146 samples were not in the range of safety and effectiveness. The results indicated that during epidural anaesthesia,by using the administration schedule of conventional dosage plus continuous epidural infusion,a satisfactory clinical effect could be obtained.Serum lidocaine concentrations of many samples were within range of safety and efficacy levels.The study showed that the administration schedule of conventional dosage and continuous epidural infusion was rational and convenient for epidural anaesthesia.

关 键 词：硬膜外麻醉 碳酸利多卡因 持续输注给药 

分 类 号：R614.42[医药卫生—麻醉学] R971.2[医药卫生—外科学]