静脉注射利多卡因对胸腔镜肺大疱切除术患者镇痛的影响  

The effect of lidocaine on postoperative pain in patients undergoing thoracoscopic resection of pulmonary bulla

作　　者：王萍[1] 丁登峰[1] 张俊志[1] 戴中亮[1] 姜远旭[1] 赵雷[1] 

机构地区：[1]暨南大学第二临床医学院附属深圳市人民医院麻醉科,广东深圳518020

出　　处：《中国实验诊断学》2015年第7期1134-1137,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的研究静脉注射利多卡因对胸腔镜肺大疱切除术患者镇痛的影响。方法选择胸腔镜肺大疱切除术患者60例,ASAⅠ-Ⅱ级,随机分为利多卡因组(L组)和生理盐水组(S组)。L组于麻醉诱导前静脉单次注射利多卡因1.5mg·kg-1,随后以2mg·kg-1·h-1持续输注至术毕,术后以1.33mg·kg-1·h-1的速度持续输注24h;S组给予等容量的生理盐水。两组患者均采用丙泊酚、瑞芬太尼全凭静脉维持麻醉。记录两组患者手术时间;术中瑞芬太尼用量;苏醒时间;术后2h(T1)、4h(T2)、8h(T3)、12h(T4)、24h(T5)和48h(T6)静息和咳嗽时的VAS评分;PCIA按压次数;恶心呕吐发生率;利多卡因不良反应。结果两组患者年龄、体重、手术时间、苏醒时间等差异均无统计学意义。L组术中瑞芬太尼用量低于S组(P<0.05)。咳嗽时VAS评分T1-T5时L组低于S组(P<0.05)。48小时PCIA按压次数L组较S组明显减少(P<0.05)。恶心呕吐发生率L组明显低于S组(P<0.05)。L组未见利多卡因相关不良反应。结论静脉注射利多卡因可降低胸腔镜肺大疱切除术患者术中阿片类药物用量,增强术后镇痛效果,减少了术后并发症的发生,治疗剂量无明显不良反应。Objective To investigate the effect of continuous infusion of lidocaine on postoperative pain in patients undergoing thoracoscopic resection of pulmonary bulla.Methods Sixty selective patients scheduled for thoracoscopic resection of pulmonary bulla were randomly divided into lidocaine group（30cases）and saline group（30cases）.L group received bolus lidocaine 1.5 mg·kg^-1 iv during anesthesia induction followed by 2 mg·kg^-1·h^-1 intraoperatively and 1.33mg·kg^-1·h^-1 for 24 hpostoperatively.S group received equal volumes of saline.Anesthesia were maintained with propofol and remifentanil.The duration of operate,total amount of remifentanil and awakening time were recorded.VAS score at 2h（T1）、4h（T2）、8h（T3）、12h（T4）、24h（T5）和48h（T6）were compared.The number of deliveries,incidence of nausea and vomiting and side effects of lidocaine were also recorded.Results Demographic data including age and weight,duration of operate and awakening time were not significantly different between groups.In L group the amount of remifentanil were significantly lower than that in S group（P〈0.05）.Compared with S group the VAS score during coughing at T1-T5 after surgery in the L group decreased significantly（P〈0.05）.In L group the number of deliveries and incidence of nausea and vomiting were significantly lower than that in S group respectively（P〈0.05）.There were no side effects of lidocaine in L group.Conclusion Intravenous lidocaine decrease opioid consumption and improve postoperative analgesia in patients undergoing thoracoscopic resection of pulmonary bulla.

关 键 词：利多卡因 胸腔镜 肺大疱 镇痛 

分 类 号：R614.2[医药卫生—麻醉学]