异丙酚、利多卡因复合液在颅脑手术麻醉中的应用  

The effects of infusion of propofol combined with lidocaine in neurosurgical patients

作　　者：张圣恭[1] 姜晓芬[1] 蓝仲岳[1] 岳军[1] 

机构地区：[1]温州医学院附属一院麻醉科,325000

出　　处：《中国基层医药》2002年第7期582-583,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　观察异丙酚、利多卡因复合液在颅脑手术麻醉中的应用价值。方法　 5 0例ASAⅠ～Ⅱ颅脑手术病人 ,随机分成两组 ,实验组采用异丙酚、利多卡因复合液 (0 8%异丙酚 +0 4 %利多卡因 ) ,对照组采用 0 8%异丙酚 ,记录麻醉前 (T1)、插管时 (T2 )、切皮 (T3)、打开脑膜 (T4 )、关脑膜 (T5 )、缝头皮 (T6 )、拔管时 (T7)的HR、SBP、DBP ;观察拔管时呛咳发生率 ;记录术毕拔管时间和清醒时间。结果　插管后实验组HR呈下降趋势 ,而对照组呈上升趋势 ,两组间差异有显著意义 (P <0 0 5 ) ;术中实验组HR平稳 ,相互间差异无显著意义 (P >0 0 5 ) ,而对照组T2、T3、T6、T7上升 ,T4下降 ,与T1比较差异有显著意义 (P <0 0 5 ) ;SBP、DBP两组麻醉后相应下降 ,拔管时两组对比差异有显著意义 (P <0 0 5 ) ;实验组无一例呛咳 ,而对照组有 4例发生呛咳 ;两组拔管时间及清醒时间差异无显著意义 (P >0 0 5 )。结论　异丙酚、利多卡因复合液能有效抑制气管插、拔管及颅脑术中各种刺激所引起的心血管反应 ,有效抑制术后呛咳的发生 。Objective To study the effects of propofol combined with lidocaine in patients underwent neurosurgery.Methods Fifty ASA grade Ⅰ to Ⅱ neurosurgical patients were assigned to two group:control group and study group.The control group received intravenous transfusion 0.8% propofol and 0.8% propofol combined with 0.4% lidocaine in study group.HR SBP and DBP were observed in seven points:before induction(T1),induction(T2),at incision(T3),opening dura(T4),closing dura(T5),suture sealf(T6),extubation(T7),remark the incidence of cough,the time of extubation and the time of regain consciousness.Results The change of HR decreased in study group and increased in control group(P<0.05),HR were kept stable in study group(P>0.05),while in the control group,HR increased in T2,T3,T6 and T7,decreased in T4,compared with T1,the difference was significant.SBP and DBP decreased in both groups after anaesthesia the changes were markedly between the two groups at extubation(P<0.05),there were no difference between the two groups of the time of extubation and regain consciousness(P>0.05),there was no postoperative cough in study group but four cases were found cough in control group.Conclusion The infusion of ropofol combined with lidocaine can effectively inhibit the cardiovascular response induced by intubation,extubation and all kings of stimulation of neurosurgery and cough after operation,while no effect is found on the time of regain consciousness.

关 键 词：异丙酚 利多卡因 颅脑手术 麻醉 心血管反应 呛咳 临床应用 

分 类 号：R614[医药卫生—麻醉学]