Objective To investigate the applied significance of adjustable low-concentration of mixed oxygenand nitrous oxide inhalation sedation combined with lidocaine local anesthesia in anorectal surgery. Methods Three hundreds patients underwent anorectal surgery in our hospital were divided into control group （n=154） and observation group （n=146）. Patients of control group underwent pure lidocaine local anesthesia， and patients of observation group underwent mixed oxygen and nitrous oxide sedation analgesia combined with lidocaine local anesthesia. Vital signs before and after operation as well as results of sedation and analgesia were compared between the 2 groups. Results Anorectal surgeries of all patients were performed successfully. There were no significant differences on change of heart rate， blood pressure， and oxygen saturation between the 2 groups before and after operation （P＞0.05）. The operation time between the control group 〔（36.3±6.8） min〕 and observation group 〔（35.4±6.5） min〕 had no statistically significant difference（t=-0.607， P=0.544）. The analgesic effects （Z=-6.859， P=0.000） and sedative effects （Z=-5.275， P=0.000） of obser-vation group were both better than those of control group. Conclusions Low-concentration of mixed oxygen and nitrous oxide inhalation sedation combined with lidocaine local anesthesia can relieve the discomfort of fear and pain， no side-impacts on vital sign before and after operation were observed，and it has better effects of sedation and analgesia， therefore it can be recommended to clinical application.
ObjectivesTo systematically review the efficacy of lidocaine injected prior to tracheal extubation in preventing hemodynamic responses to tracheal extubation in general anesthesia.MethodsPubMed, Ovid, Web of Science, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of lidocaine administrated prior to extubation in preventing hemodynamic responses to tracheal extubation in patients undergoing general anesthesia from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 13.0 software.ResultsA total of 10 RCTs involving 525 patients were included. The results of meta-analysis showed that: compared with control group, lidocaine could reduce mean arterial pressure in 5 min after extubation (MD=–5.10, 95%CI –9.41 to –0.79, P=0.02), weaken the increase in systolic blood pressure caused by extubation from the moment before extubation to 5 minutes after extubation (before extubation: MD=–7.22, 95%CI –10.34 to –4.11, P<0.000 01; at extubation: MD=–14.02, 95%CI –19.42 to –8.62, P<0.000 01; 1 minutes after extubation: MD=–15.82, 95%CI –22.20 to –9.45, P<0.000 01; 3 minutes after extubation: MD=–12.55, 95%CI –20.36 to –4.74, P=0.002; and 5 minutes after extubation: MD=–12.05, 95%CI –20.35 to –3.74, P=0.004), and weakened extubation-induced increase in diastolic blood pressure at extubation (MD=–9.71, 95%CI –16.57 to –2.86, P=0.005). In addition, lidocaine inhibited heart rate in all time points except the moment of before and at 10 minutes after extubation.ConclusionsCurrent evidence shows that lidocaine can inhibit the increase in blood pressure and heart rate caused by extubation at certain times. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.
ObjectiveTo explore the effect of lidocaine on postoperative pain management after throat surgery. MethodsSixty patients undergoing throat surgery between June 2011 and May 2013 were randomly divided into trial group and control group, with 30 in each group. Patients in the trial group accepted lidocaine for pain management, while the control group used dicaine. Pain management effect was observed and compared between the two groups. ResultsThe pain scores of patients at hour 0.5, 2.0, 6.0, and 24.0 after surgery were 2.7±0.8, 2.2±0.9, 1.7±0.8, and 1.5±0.3 in the trial group, and 4.7±1.1, 4.2±0.8, 3.4±0.7, and 2.9±0.5 in the control group, and the differences were significant (P<0.05). Postoperative incidences 6.7% in the trial group, and 30.0% in the control group, and the difference was also significant (P<0.05). ConclusionLidocaine can reduce the pain of patients in postoperative pain management after throat surgery, with such advantages as long-time functioning, no toxic side effect, and obvious effect, which is worth promoting.
Objective To investigate the effectiveness of pretreatment with mixture of lidocaine and flurbiprofen axetil in reducing injection pain of propofol. Methods One hundred and sixty ASI I–II patients undergoing general anaesthesia were randomly allocated into four groups (40 cases in each group): the control group, the lidocaine (Lc) group, the flurbiprofen axetil (FA) group and the mixture of lidocaine and flurbiprofen axetil (hereafter termed as “mixture”) group. After the occlusion of venous drainage, patients were pretreated with 7 mL of 0.9% saline in the control group, 5 mL (50 mg) of flurbiprofen axetil and 2 mL of 0.9% saline in the FA group, 2 mL (40 mg) of 2% lidocaine and 5 mL of 0.9% saline in the Lc group, and 5 mL (50 mg) of flurbiprofen axetil and 2 mL (40 mg) of 2% lidocaine in the mixture group, respectively. The occlusion was released 2 min later and then 0.5 mg/kg propofol was injected into the vein within 5 s. During injecting propofol, the patients were asked by another anesthetist to assess and record their pain through using VSR. Results No significant differences in the demographic characteristics were found among the four groups. In comparison with the control group, the incidence rates of propofol injection pain were obviously lower in the mixture group, the FA group and the Lc group (Plt;0.05); there was a significant reduction in the incidence rate of pain in the mixture group compared with the other three groups. The median pain score was significantly lower in the mixture group and the Lc group than that in the control group. During the 24 hour follow-up after operation, neither the adverse events such as red-swelling in injection site, phlebitis or drug eruption, nor the gastrointestinal stimulating signs were found. Conclusion The mixture of flurbiprofen axetil and lidocaine is found to be more effective in reducing injection pain of propofol.
ObjectivesTo systematically review the efficacy of dyclonine and lidocaine for preparation before gastroscopy.MethodsPubMed, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of dyclonine vs. lidocaine for preparation before gastroscopy from inception to December 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 11 RCTs were included. The results of meta-analysis showed that: dyclonine could improve anesthetic effect (RR=1.38, 95%CI 1.31 to 1.47, P<0.000 01), and was more capable to remove bubble (RR=1.40, 95%CI 1.28 to 1.52,P<0.000 01), and had superior textures (RR=1.43, 95%CI 1.18 to 1.74,P=0.000 3).ConclusionsOral dyclonine can improve the visual definition of gastric mucosa and anesthetic effect, and has superior textures. Thus, dyclonine can be regarded as a recommended option prior to gastroscopy. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective To systematically review the effects of lidocaine for preventing pain on injection of propofol. Methods Databases including The Cochrane Library (Issue 4, 2012), PubMed, MEDLINE, Ovid, HighWire, EMbase, CBM and CNKI were searched electronically to collect literature published from January, 1985 to December, 2012. Randomized controlled trials (RCTs) were indentified about lidocaine for preventing injection pain of propofol. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assess the quality of the included studies. Then meta-analysis was performed using RevMan 5.1 software. Results Fifteen trials involved 1 332 patients were included. The results of meta-analysis indicated that, adding lidocaine into propofol lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.36, 95%CI 0.30 to 0.44, Plt;0.000 01); using different doses of lidocaine before injection lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.59, 95%CI 0.47 to 0.75, Plt;0.000 1); using different doses of lidocaine after venous occlusion lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.44, 95%CI 0.37 to 0.52, Plt;0.000 01). Conclusion Lidocaine could reduce the pain on injection of propofol. Using lidocaine 40 mg after venous occlusion is a relatively effective method to lower the incidence of pain on injection which is more suitable for outpatient who receive intravenous anesthesia without preoperation medication.
目的 研究利多卡因對海馬的神經毒性是否會對大鼠空間學習記憶能力產生影響，并探討大鼠空間學習能力的變化與海馬CA3區錐體細胞數目的相關性。 方法 將成年Wistar雄性大鼠隨機分為基礎值組（n=7）和利多卡因驚厥組（n=40）。基礎值組大鼠靜脈給予生理鹽水后使用Y迷宮測定大鼠的空間學習能力。利多卡因驚厥組大鼠尾靜脈持續輸注利多卡因造成驚厥，待大鼠恢復正常運動以后放入鼠籠重新飼養。并于驚厥后第1、3、5、7天從中隨機抓取大鼠測試其空間學習能力以及組織學改變。根據對應天數將利多卡因驚厥組的40只大鼠隨機細分為Day-1、Day-3、Day-5、Day-7亞組，每亞組10只。所有大鼠在測定空間學習能力之后立即處死，取出大腦并做石蠟包埋，冠狀面切片后進行組織學檢測，顯微鏡下評估海馬CA3區錐體細胞狀態。 結果 ① 基礎值組和Day-1、Day-3、Day-5、Day-7亞組大鼠的Y迷宮穿梭次數分別為（25.2 ± 3.7）、（27.1 ± 8.1）、（36.9 ± 9.9）、（38.7 ± 10.6）、（40.6 ± 16.3）次，除Day-1亞組與基礎值組比較差異無統計學意義（P＞0.05）外，其余各亞組與基礎值組差異均有統計學意義（P＜0.05）；② 與基礎值組單位面積（10.3 ± 4.5）個（異常錐體）細胞比較，利多卡因驚厥組大鼠海馬CA3區異常錐體細胞數增加，Day-1、Day-3、Day-5、Day-7亞組計數值分別為13.0 ± 7.2、15.6 ± 5.0、19.6 ± 8.1、18.1 ± 5.1，且與大鼠Y迷宮穿梭次數呈正相關（r=0.711，P＜0.05）。 結論 利多卡因引起的驚厥使成年大鼠海馬依賴性空間學習能力下降，利多卡因的神經毒性引起的海馬異常錐體細胞增多可能是造成這一現象的一種原因。
目的 觀察不同濃度腎上腺素與利多卡因混合液頭皮浸潤注射對開顱術患者血流動力學的影響。方法 選取2010年5月－10月80例顱內腫瘤患者，隨機分成4組，行1%利多卡因溶液混合不同濃度的腎上腺素16 mL頭皮浸潤注射。腎上腺素濃度：A組2.5 μg/mL、B組5.0 μg/mL、C組7.5 μg/mL、D組10.0 μg/mL。記錄注射前（T0）、注射后5 min內（T1-10）心率（HR）、平均動脈壓（MAP）、收縮壓（SBP）、舒張壓（DBP），根據各時段的MAP最低值和最高值，計算MAP的降低率和升高率，計數各組MAP下降10%以內、10%～20%和20%以上的例數。 結果 C組的MAP下降例數最多且MAP下降率最高，與其他組間比較差異有統計學意義（P＜0.05）。組內比較，C組MAP、SBP在1.5、2.0、2.5 min時、DBP在2 min時和D組MAP和DBP在1.5、2.0 min時下降差異有統計學意義（P＜0.05）。4組血壓下降的同時伴HR增快，但HR組間差異無統計學意義（P＞0.05）。 結論 低濃度的腎上腺素與10%利多卡因混合液用于開顱術患者頭皮浸潤注射時可導致血壓下降。