Narcotrend监测下静注利多卡因在宫腔镜手术麻醉中的应用  

Application of intravenous lidocaine in patients undergoing hysteroscopy surgery under Narcotrend monitoring

作　　者：汪华新[1] 詹丽英[1] 彭璇[1] 肖业达[1] 贾强[1] 赵博[1] 

机构地区：[1]武汉大学人民医院麻醉科,武汉市430060

出　　处：《实用医学杂志》2017年第18期3064-3066,共3页The Journal of Practical Medicine

基　　金：中央高校基本科研业务费专项基金(编号:2042017kf0144)

摘　　要：目的观察Narcotrend麻醉深度指数(NT)监测下静注利多卡因在宫腔镜手术中的应用效果。方法 80例择期宫腔镜手术患者,随机分为生理盐水组(S组)和利多卡因组(L组)。L组于麻醉诱导前静脉注射利多卡因1.5 mg/kg作为负荷量,随后以2 mg/(kg·h)持续输注至术毕;S组给予等容量的生理盐水。两组患者均采用NT监测麻醉镇静深度,麻醉方式为丙泊酚、瑞芬太尼全凭静脉麻醉。记录两组患者手术时间(T_1),丙泊酚和瑞芬太尼总量,苏醒时间(T_2),术后0.5 h(T_3),4 h(T_4),24 h(T_5)静息时的术后视觉模拟评分(VAS),咽喉疼痛发生率,利多卡因不良反应。结果两组患者的年龄、体质量、T_1、T_2和丙泊酚总量差异均无统计学意义(P>0.05)。L组瑞芬太尼用量明显少于S组(P<0.05)。静息时VAS评分T_3,T_4时L组低于S组(P<0.05),而T_5无明显差异。咽喉疼痛发生率L组明显低于S组(P<0.05)。L组未见利多卡因不良反应。结论 Narcotrend监测下静脉输注利多卡因可以安全有效地应用于宫腔镜手术。Objective To observe intravenous lidocaine in patients undergoing hysteroseopy surgery under Narcotrend monitoring. Methods 80 patients undergoing elective hysteroseopy surgery were randomly divided into normal saline group （group S ） and lidocaine group （ group L）. Before anesthesia induction, group L was given lido- eaine injection of 1.5 mg/kg, then with 2 mg/（kg·h） for infusion to the end of surgery. Group S received normal sa- line instead of lidoeaine as the control. All patients received Narcotrend （NT） monitoring anesthesia depth of seda- tion and received intravenous anesthesia with propofol and remifentanil. Operation time （T1） , dosage of propofol and remifentanil, total waking time （T2）, postoperative pain of 0.5 h （T3） , 4 h （T4） , 24 h （T5） by postoperative visual analogue scale （VAS） , incidence of sore throat, lidocaine adverse reactions were recorded. Results Age, weight, T1, T2 and dosage of propofol between two groups had no statistical significance （P 〉 0.05）. Dosage of remifentanil of group L was obviously less than that in group S （ P 〈 0.05 ）. VAS score T3, T4 of group L was obviously less than those in group S （P 〈 0.05 ）. No significant difference was found on T5. Sore throat incidence of group L was lower than that in group S （ P 〈 0.05 ）. Lidocaine adverse reactions were not found in L group. Conclusions Intravenous lidoeaine in hvsteroscopy surgery is safe and effective under Narcotrend monitoring.

关 键 词：Narcotrend监测 利多卡因 宫腔镜手术 

分 类 号：R614[医药卫生—麻醉学]