利多卡因预防全身麻醉下止血带诱导高血压的研究  

Study on the Prevention of Hypertension Induced by Tourniquet under General Anesthesia with Lidocaine

作　　者：陈烨[1] 邹聪华[1] 吴晓丹[1] CHEN Ye;ZOU Conghua;WU Xiaodan(Department of Anesthesiology,Fujian Provincial Hospital,Fuzhou,Fujian Province,350000 China)

机构地区：[1]福建省立医院麻醉科,福建福州350000

出　　处：《中外医疗》2023年第34期76-79,87,共5页China & Foreign Medical Treatment

摘　　要：目的 探讨单次静注利多卡因对预防止血带诱导的高血压(tourniquet-induced hypertension, TIH)的效果,并比较利多卡因与氯胺酮在全身麻醉患者中的作用。方法 通过随机、对照、双盲方法,方便选择2021年7月—2023年1月在福建省立医院南院进行下肢手术并使用止血带的患者75例。患者分别给予利多卡因(利多卡因组,1.5 mg/kg,n=25)、氯胺酮(氯胺酮组,0.2 mg/kg,n=25)及生理盐水(生理盐水组,n=25),在止血带充气前10 min静脉给药。在止血带充气之前,以10 min的间隔在止血带充气60 min后以及放气后立即测量收缩压(systolic blood pressure, SBP),舒张压(diastolic blood pressure, DBP)和心率(heart rate, HR),并记录TIH的发病率。结果 与利多卡因和氯胺酮组相比,对照组的SBP、DBP和HR在止血带充气后60 min内显著增加,差异有统计学意义(P<0.05)。利多卡因组(16%)和氯胺酮(12%)组的TIH发生率显著低于对照组(56%),差异有统计学意义(χ^(2)=14.231,P<0.05)。结论 单次推注利多卡因可有效缓解止血带充气引起的血压升高,其效果与推注氯胺酮相当。Objective To investigate the effect of single intravenous lidocaine on the prevention of tourniquet-induced hypertension(TIH)and compare the effect of lidocaine with ketamine in patients under general anesthesia.Methods A total of seventy-five patients who underwent lower extremity surgery and applied tourniquet in the South Hospital of Fujian Provincial Hospital from July 2021 to January 2023 were conveniently selected through a randomized,con-trolled,double-blind method.Patients were given lidocaine(lidocaine group,1.5 mg/kg,n=25),ketamine(ketamine group,0.2 mg/kg,n=25),and saline(saline group,n=25).Administer intravenously 10 minutes before the tourniquet was inflated.Systolic blood pressure(SBP),diastolic blood pressure(DBP),and heart rate(HR)were measured at 10-minute intervals 60 minutes after the tourniquet was inflated and immediately after the tourniquet was deflated.The in-cidence of TIH was recorded.Results Compared with the lidocaine group and ketamine group,SBP,DBP,and HR in the control group were significantly increased within 60 minutes after tourniquet inflation,and the difference was sta-tistically significant(P<0.05).TIH incidence in lidocaine group(16%)and ketamine(12%)group were significantly lower than that in control group(56%),and the difference was statistically significant(χ^(2)=14.231,P<0.05).Conclusion A single intravenous lidocaine can effectively relieve the increase in blood pressure caused by tourniquet inflation,and the effect is comparable to that of ketamine injection.

关 键 词：高血压 氯胺酮 利多卡因 疼痛 止血带 

分 类 号：R4[医药卫生—临床医学]