芬太尼静注联合利多卡因局部浸润对开颅血流动力学反应的预防作用  

The preventive effect of intravenous fentanyl with local lidocaine infiltration on the hemodynamic response to craniotomy

作　　者：于涛[1] 高崇荣[1] 卢振和[1] 赵雾红[1] 钱耀亮[1] 王海龙 

机构地区：[1]广州医学院附属第二医院,广东广州510260 [2]广州市新海医院,广东广州510300

出　　处：《现代医院》2004年第2期26-27,共2页Modern Hospitals

摘　　要：目的探讨芬太尼静注与利多卡因局部浸润对开颅血流动力学反应的预防效果。方法60例ASAⅠ～Ⅱ级择期行脑肿瘤切除手术病人随机被分为三组,每组20例。F组静脉给予芬太尼5μg/,5min后切头皮;L组05%利多卡因40ml沿切口及剥离范围浸润至骨膜,1min后切头皮;FL组联合应用L组和F组方法,记录麻醉前(基础值)、切头皮前(气管插管后15min)、切头皮时和切颅骨时的HR、MAP。结果F组和L组切头皮与颅骨时的HR、MAP均显著高于FL组(P<005或001),FL组切头皮前、切头皮时与切颅骨时的HR和MAP值较麻醉前无显著性差异(P>005)。结论静注芬太尼与切口处利多卡因局部浸润联合应用对开颅血流动力学反应有较好的预防作用。Objective: To investgate the preventive effects of intravenous fentanyl and local lidocaine infiltration on the hemodynamic response to craniotomy. Methods: sixty patients scheduled for elective craniotomy were studied. They were randomly divided into three groups. Group F received fentanyl 5 microg/kg IV 5 min before scalp incision, group L was administered plain lidocaine 40 ml 0.5% by infiltration into the periosteum along the sclap area 1 minute before incision, and both methods were applied together in group FL. Heart rate (HR) and mean blood pressure (MAP) were recorded at the time of preinduction (baseline), pre-scalp incision (15 min after induction), scalp incision and skull incision. Results: In group F and L group L during scalp incision and skull incision, HR and MAP were significantly higher than in the FL groups ( P <0.05 or 0.01). In the FL group, there was no significant increase in HR or MAP at any time of the recordings. Conclusions: We conclude that intravenous fentanyl with local infiltration of lidocaine into the periosteum is effective in reducing the hemodynamic response to craniotomy.

关 键 词：芬太尼 静脉滴注 利多卡因 局部浸润 开颅手术 血流动力学 并发症 剂量 

分 类 号：R651.11[医药卫生—外科学] R614[医药卫生—临床医学]