靜脈利多卡因對無痛胃鏡檢查中異丙酚全身麻醉的影響_《華西醫學》

作者：

薛瑛 ,  劉進

四川大學華西醫院麻醉科（成都，610041）;

關鍵詞：

靜脈利多卡因異丙酚無痛胃鏡檢查

DOI：

10.7507/1002-0179.20130271

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目的　探究靜脈利多卡因聯合異丙酚在無痛胃鏡麻醉應用中的可行性、安全性和有效性。方法　納入2012年4月－5月行無痛胃鏡檢查的患者102例，隨機分為兩組：利多卡因組（L組）和生理鹽水組（S組）。L組于麻醉誘導前緩慢靜注2%利多卡因2 mg/kg，S組給予相同容量的生理鹽水。比較兩組間的異丙酚誘導劑量、追加劑量和總量，以及檢查中嗆咳反應、體動的發生率，麻醉時間，不良事件和不良反應發生率，麻醉醫生和患者滿意度是否有差異。結果　 L組較S組異丙酚誘導劑量減少約0.17 mg/kg，差異有統計學意義（P=0.03）；余指標差異均無統計學意義。結論　將靜脈利多卡因用于無痛胃鏡麻醉，雖能減少異丙酚誘導劑量，但減少程度并不明顯；不能改善誘導前后血流動力學的劇烈波動，也未能縮短總的麻醉時間；在抑制術中嗆咳反應、體動方面也未見明顯優勢。無論是從安全性還是經濟學方面考慮，我們都不推薦將靜脈利多卡因聯合異丙酚麻醉的方案用于無痛胃鏡檢查。

引用本文： 薛瑛,劉進. 靜脈利多卡因對無痛胃鏡檢查中異丙酚全身麻醉的影響. 華西醫學, 2013, 28(6): 864-867. doi: 10.7507/1002-0179.20130271 復制

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13.	Punjasawadwong Y, Boonjeungmonkol N, Phongchiewboon A. Bispectral index for improving anesthetic delivery and postoperative recovery[J]. Anesth Analg, 2008, 106(4): 1326.
14.	Nordmark J, Rydqvist B. Local anaesthetics potentiate GABA-mediated Cl-currents by inhibiting GABA uptake[J]. Neuroreport, 1997, 8(2): 465-468.
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1. 　Classen M, Tytgat GNJ, Lightdale CJ. Gastroenterological endoscopy[M]. 2nd edition. Germany: Georg Thieme Verlag, 2010: 106-116.
2. 　Sebel PS, Lowdon J D. Propofol: a new intravenous anesthetic[J]. Anesthesiology, 1989, 71(2): 260-277.
3. 　米勒. 米勒. 麻醉學·上卷[M]//曾因明, 鄧小明, 譯. 6版. 北京：北京大學醫學出版社, 2006: 324-330.
4. 　Cressey DM, Bhaskaran NC, Reilly CS. Effect of midazolam pretreatment on induction dose requirements of propofol in combination with fentanyl in younger and older adults[J]. Anaesthesia, 2001, 56(2): 108-113.
5. 　Bailey PL, Pace NL, Ashburn MA, et al. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl[J]. Anesthesiology, 1990, 73(5): 826-830.
6. 　Himes RS Jr, DiFazio CA, Burney RG. Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane[J]. Anesthesiology, 1977, 47(5): 437-440.
7. 　Kaba A, Laurent S R, Detroz B J, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy[J]. Anesthesiology, 2007, 106(1): 11-18.
8. 　Kelsaka E, Karakaya D, Baris S, et al. Effect of intramuscular and intravenous lidocaine on propofol induction dose[J]. Med Princ Pract, 2011, 20(1): 71-74.
9. 　Yukioka H, Yoshimoto N, Nishimura K, et al. Intravenous lidocaine as a suppressant of coughing during tracheal intubation[J]. Anesth Analg, 1985, 64(12): 1189-1192.
10. 　Aouad, MT, Savvid SS, Zalaket MI, et al. Intravenous lidocaine as adjuvant to sevoflurane anesthesia for endotracheal intubation in children[J]. Anesth Analg, 2003, 96(5): 1325-1327.
11. 　Baik H J, Kim Y J, Kim J H. Lidocaine given intravenously improves conditions for laryngeal mask airway insertion during propofol target-controlled infusion[J]. Eur J Anaesthesiol, 2009, 26(5): 377-381.
12. 　Gaughen CM, Durieux M. The effect of too much intravenous lidocaine on bispectral index[J]. Anesth Analg, 2006, 103(6): 1464-1465.
13. 　Punjasawadwong Y, Boonjeungmonkol N, Phongchiewboon A. Bispectral index for improving anesthetic delivery and postoperative recovery[J]. Anesth Analg, 2008, 106(4): 1326.
14. 　Nordmark J, Rydqvist B. Local anaesthetics potentiate GABA-mediated Cl-currents by inhibiting GABA uptake[J]. Neuroreport, 1997, 8(2): 465-468.
15. 　Moore JM, Liu SS, Neal JM. Premedication with fentanyl and midazolam decreases the reliability of intravenous lidocaine test dose[J]. Anesth Analg, 1998, 86(5): 1015-1017.

《華西醫學》

靜脈利多卡因對無痛胃鏡檢查中異丙酚全身麻醉的影響

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《華西醫學》

靜脈利多卡因對無痛胃鏡檢查中異丙酚全身麻醉的影響

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