持续静注利多卡因对乳腺癌根治术患者术中麻醉用药量及术后恢复质量的影响  

Effect of continuous intravenous injection of lidocaine on intraoperative anesthetic dosage and postoperative recovery quality in patients undergoing radical mastectomy

作　　者：魏兰璎 孟丽华[1] 李喆[1] 雷晓鸣[1] WEI Lanying;MENG Lihua;LI Zhe;LEI Xiaoming(Department of Anesthesiology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Shaanxi Province,China)

机构地区：[1]西安交通大学第二附属医院麻醉科,陕西西安710004

出　　处：《世界临床药物》2023年第7期740-744,共5页World Clinical Drug

摘　　要：目的观察持续静注利多卡因对乳腺癌根治术全麻患者术中麻醉用药量、术后疼痛以及术后恢复质量的影响。方法选取2021年5月至2022年5月于本院择期全麻下行乳腺癌根治术患者80例,采用随机数字表法将患者分为观察组和对照组,每组40例。观察组麻醉诱导前静注利多卡因1 mg/kg,然后以2 mg/kg·h持续泵注至手术结束停药;对照组以同样方法给予等容量生理盐水。记录术中丙泊酚与瑞芬太尼用量;评估术后2、6、12及24 h视觉模拟评分法(visual analogue scale,VAS)疼痛程度,以及术后补救镇痛例数。比较术后24 h及术后7 d通过40项恢复质量评分(the 40 item quality of recovery score,QoR-40)评估患者术后恢复情况。结果观察组术中丙泊酚和瑞芬太尼用量均少于对照组(P<0.05);术后2、6及12 h,观察组的VAS评分均低于对照组,且观察组的补救镇痛率(7.5%)低于对照组(25%,P<0.05);术后24 h及术后7 d,观察组的QoR-40总评分均高于对照组(P<0.05)。结论术中持续静注利多卡因可减少乳腺癌根治术全麻患者术中麻醉药物用量,减轻术后疼痛,改善术后恢复质量。Objective To observe the effect of continuous intravenous injection of lidocaine on intraoperative anesthetic dosage,postoperative pain and postoperative recovery quality of patients undergoing general anesthesia for radical mastectomy.Methods A total of 80 patients undergoing radical mastectomy under elective general anesthesia in our hospital from May 2021 to May 2022 were selected and divided into observation group and control group by random number table method,with 40 cases in each group.In the observation group,1 mg/kg lidocaine was given intravenously before anesthesia induction,and then 2 mg/kg was pumped continuously until the end of operation.The control group was given equal volume normal saline in the same way.The intraoperative dosage of propofol and remifentanil were recorded.Visual analogue scale(VAS)was used to evaluate the degree of pain at 2,6,12 and 24 hours after operation,and the number of patients with rescue analgesia was observed.The 40 item quality of recovery score(QoR-40)was used to evaluate the postoperative recovery of patients at 24 h and 7 d after operation.Results Compared with the control group,the intraoperative dosage of propofol and remifentanil in the observation group was less than that in the control group(P<0.05).At 2 h,6 h and 12 h after operation,the VAS score of the observation group were lower than those of the control group,and the rescue analgesia rate of the observation group(7.5%)was lower than that of the control group(25%,P<0.05).At 24 h and 7 d after operation,the total score of QoR-40 in the observation group was higher than that in the control group(P<0.05).Conclusions Continuous intraoperative lidocaine injection can reduce the amount of anesthesia drugs,relieve postoperative pain and improve postoperative recovery quality in patients with general anesthesia during radical mastectomy.

关 键 词：利多卡因 乳腺癌根治术 麻醉方式 术后恢复质量 40项恢复质量评分 

分 类 号：R971.2[医药卫生—药品] R737.3[医药卫生—药学]