利多卡因联合硫酸镁静脉泵注治疗顽固性三叉神经痛20例临床研究  

Intravenous infusion lidocaine and magnesium sulphuricum for management of intractable trigeminal neuralgia:a case series of 20 patients and evidence review

作　　者：乔国艳 林显文 叶源才 梁鹏[2] QIAO Guoyan;LIN Xianwen;YE Yuancai(Department of Internal Medicine,Chengfei Hospital,Chengdu,Chengdu 610091)

机构地区：[1]成都市成飞医院内科,成都610091 [2]四川大学华西医院麻醉手术中心,成都610041

出　　处：《陕西医学杂志》2020年第10期1237-1239,1243,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81600918)。

摘　　要：目的:探讨使用利多卡因联合硫酸镁静脉泵注治疗神经病理性疼痛的方法,提高顽固性三叉神经痛的治疗效果。方法:对治疗神经病理性疼痛常规用药治疗方案不佳的20例顽固性三叉神经痛患者,维持原有药物治疗的基础上,使用利多卡因100 mg/kg复合硫酸镁1.25 g,1 h静脉泵注完,1次/周,共计3周方案,观察治疗前后使用视觉模拟评分(VAS),抑郁自评量表(SDS)及焦虑自评量表(SAS)评估患者疼痛及抑郁焦虑评分的变化。结果:一共治疗顽固性三叉神经痛患者20例,所有患者在接受3个疗程的治疗后,疼痛均得到不同程度缓解,治疗前后比较差异有统计学意义(P<0.05),2例患者曾出现一过性头昏乏力,无抽搐等局麻药中毒反应及其他严重不良反应;所有20例患者治疗前后焦虑抑郁评分均高于全国常模,且差异有统计学意义(P<0.05),治疗后焦虑抑郁评分较治疗前有所下降,但差异无统计学意义(P>0.05)。结论:利多卡因联合硫酸镁静脉泵注射治疗顽固性三叉神经痛取得良好的治疗效果,且无严重不良反应。Objective:To explore the method of lidocaine combined with magnesium sulfate intravenous infusion in the treatment of neuropathic pain and improve the therapeutic effect of intractable trigeminal neuralgia.Methods:We used a novel protocol to treat 20 patients for management of intractable neuropathic pain with severe TN by using an intravenous infusion of a combination of 100 mg/kg lidocaine and 1.25 g magnesium sulphuricum for 1 hour,once a week for 3 weeks.The scores of pain,depression and anxiety were evaluated before and after therapy by VAS,SDS and SAS.Results:All patients experienced sound pain relief after the combined intravenous infusion therapy(P<0.05).Two patients experienced short and mild dizziness after the therapy,but no severe side effects were reported.The scores of depression and anxiety of all patients were higher than norm(P<0.05).The scores of anxiety and depression decreased after therapy,but the difference was not statistically significant(P>0.05).Conclusion:Intravenous magnesium sulphuricum and lidocaine is an effective and safe supplement method for management of intractable trigeminal neuralgia patients.

关 键 词：三叉神经痛 硫酸镁 利多卡因 神经病理性疼痛 抑郁 焦虑 

分 类 号：R745.1[医药卫生—神经病学与精神病学]