口腔含漱利多卡因在肥胖患者行无痛胃镜检查中的应用  

Application of Oral Rinse Lidocaine in Obese Patients Undergoing Painless Gastroscopy

作　　者：徐广民[1] 范丹[1] 李鹏[1] 苏文杰[1] Xu Guangmin Fan Dan Li Peng et al.(Sichuan Academy of Medical Sciences · Sichuan Provincial People＇s Hospital, Chengdu, Sichuan 610072, China)

机构地区：[1]四川省医学科学院.四川省人民医院麻醉科,四川成都610072

出　　处：《四川医学》2017年第4期421-424,共4页Sichuan Medical Journal

摘　　要：目的观察口腔含漱利多卡因复合丙泊酚用于肥胖患者行无痛胃镜检查的效果及安全性。方法选择体质指数(BMI)≥30kg/m^2行无痛胃镜检查的肥胖患者150例,随机分为对照组(D组)和利多卡因组(L组)。对照组给予生理盐水5mL口腔含漱3min静脉注射20μg芬太尼后缓慢推注丙泊酚1.5mg/kg;利多卡因组给予2%利多卡因5mL口腔含漱3min静脉注射20μg芬太尼后缓慢静推丙泊酚1.5mg/kg。术中如有体动反应,追加丙泊酚0.5~1mg/kg。比较两组患者的麻醉效果、不同时间点氧饱和度,平均动脉压及心率,诱导时间,手术时间,术后睁眼时间、定向力及认知力恢复的时间,术中并发症。结果 L组在丙泊酚用量,术中氧饱和度,平均动脉压及心率,术后睁眼时间、定向力、认知力恢复的时间和术中并发症的发生率等方面均优于D组,差异有统计学意义(P<0.05)。结论两种麻醉方法均可以应用于临床。口内含漱利多卡因复合使用镇痛、镇静药物可以提高患者的耐受性,显著减少丙泊酚用量,且检查期间呼吸和循环系统并发症发生率更低,更适合肥胖患者的无痛胃镜检查。Objective To observe the efficacy and safety of oral rinse lidocaine combined with propofol for obese patients undergoing painless gastroscopy. Methods 150 obese patients of which the body mass index（ BMI） was ≥30kg/m～2 undergoing painless gastroscopy were randomly divided into control group（ group D） and lidocaine group（ group L）. The control group was given5 mlnormal saline oral rinse for 3min,after intravenous injection of 20μg fentanyl,slow infusion of 1. 5mg/kgpropofol. The lidocaine group received 2% lidocaine 5ml oral rinse for 3min,after intravenous injection of 20μg fentanyl,slow infusion of 1. 5mg/kgpropofol.During the operation,if there was a physical reaction,additional propofol 0. 5 ～ 1mg/kg. The anesthetic effect of the two groups of patients at different time points,oxygen saturation,the mean arterial pressure and heart rate,induction time,operation time,postoperative recovery time of eye opening,orientation and cognitive time,and intraoperative complications were compared. Results In group L,the dosage of propofol,oxygen saturation during the operation,the mean arterial pressure and heart rate,eye opening time,time of directional force and cognitive recoveryand the incidence of intraoperative complicationswere all higher than those of group D（ P〈0. 05）. Conclusion Two kinds of anesthesia methods can be applied to clinical. Oral rinse lidocaine combined with analgesic,sedative drugs can improve the tolerance of patients,significantly reduce the dosage of propofol,and the incidence of respiratory and circulatory complications is lower during the examination,which is more suitable for painless gastroscopy in patients with obesity.

关 键 词：肥胖症 丙泊酚 利多卡因 胃镜检查 

分 类 号：R614[医药卫生—麻醉学]