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。
Objective To assess the anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis. Methods We electronically searched PubMed, EMbase, Cochrane Library (Issue 4, 2009), CNKI, VIP and CBM. The search was updated to December 2009. Randomized controlled trials (RCTs) and quasi-RCTs were indentified about articaine and lidocaine for irreversible pulpitis. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. And RevMan5.0 was applied for statistical analysis in success rate. Results Nine trials involving 985 pulpitis patients were included. Meta-analysis indicated that, both the anesthetic success rate (RR=1.33, 95%CI 1.23 to1.44) and maxillary anesthetic success rate (RR=1.65, 95%CI 1.38 to 1.98) of articaine were superior to that of lidocaine, but there was no statistical significance in mandibular anesthetic success rate between two groups (RR=1.28, 95%CI 0.97 to 1.69). Conclusion The current evidence shows that articaine is superior to lidocaine in anesthetic efficacy, and is good at maxillary anesthesia.
【摘要】 目的 比較利多卡因不同劑量預處理對羅庫溴銨注射痛的影響。 方法 120例行全身麻醉擇期手術的患者按照完全隨機的方法分為利多卡因10 mg 3 mL預處理組（A組），利多卡因25 mg 3 mL預處理組（B組），利多卡因50 mg 3 mL預處理組（C組），生理鹽水3 mL預處理組（D組）。觀察不同劑量的利多卡因預處理對羅庫溴銨注射痛的影響。 結果 A、B、C和D組注射羅庫溴銨的疼痛發生率分別為53%、27%、3%和90%。與生理鹽水預處理組相比，利多卡因預處理組能明顯減輕羅庫溴銨引起的注射痛（Plt;0.01）；劑量越大，效果越明顯。 結論 利多卡因10、25、50 mg預處理均能顯著降低羅庫溴銨注射時引起的疼痛，以50 mg利多卡因更為有效。【Abstract】 Objective To compare the effects of different doses of lidocaine pretreatment on the pain from injection with rocuronium. Methods One hundred and twenty patients of general anesthesia had undergone elective surgery, were randomly divided into lidocaine 10 mg 3 mL pretreated group (group A), lidocaine 25 mg 3 mL pretreated group (group B), lidocaine 50 mg 3 mL pretreated group (group C) and saline 3 mL pretreated group (group D). The effects of different doses of lidocaine pretreatment on injection pain of rocuronium were observed. Results The pain incidence from injection with rocuronium in A, B, C, D groups were 53%, 27%, 3% and 90% respectively. The higher dose of lidocaine, the more obvious effect. Conclusion Lidocaine pretreatment with 10, 25, 50 mg can reduce the severity of pain from injection with rocuronium, and lidocaine 50 mg is the most effective.
目的 比較預注射利多卡因和局部加溫緩解羅庫溴銨注射痛效果。 方法 選取2011年3月－8月擇期行腹腔鏡下膽囊切除術的150例患者，按照完全隨機的方法分為利多卡因組（L組）、局部加溫組（W組）、對照組（C組）,每組各50例患者。W組患者在留置針部位用Bair Hugger以40 °C加溫1 min；L組患者用橡膠止血帶在靜脈近端加壓直至靜脈輸液停止走行，推注1%利多卡因2 mL，1 min后松開止血帶。隨后3組患者均在2 s內靜脈推注1 mL羅庫溴銨注射液（含羅庫溴銨10 mg）。觀察在注射羅庫溴銨前預先注射利多卡因及局部加溫緩解注射痛的效果。 結果 羅庫溴銨注射痛的發生率在W組、L組、C組中分別為62%、34%、82%。C組的疼痛發生率最高（P＜0.05）；W組的疼痛率高于L組（P＜0.05）；與W、L組相比，C組的重度疼痛率最高（P＜0.05）；L組的中、重度疼痛率低于W組（P＜0.05）。 結論 預注射利多卡因和局部加溫均能有效緩解羅庫溴銨引起的注射痛，預注射利多卡因對于緩解羅庫溴銨引起的注射痛更為有效。
ObjectiveTo systematically review the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion. MethodsWe searched PubMed, EMbase, The Cochrane Library, WanFang Data, VIP, CBM and CNKI databases concerning randomized controlled trial (RCT) of the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion from their inception to January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software. ResultsSix RCTs involving 384 patients were included. The results of meta-analysis showed that there were no significant differences between the lidocaine group and the saline group in pain and discomfort scores (MD=-25.35, 95%CI -30.37 to -24.33) and first successful insertion rate (RR=1.38, 95%CI 1.21 to 1.57). ConclusionIntranasal lidocaine spray before nasogastric tube insertion could reduce patient pain and discomforts related to the procedure, and improve the first successful insertion rate.
目的:比較芬太尼與利多卡因宮旁阻滯麻醉在人工流產術中的療效。方法:選擇我院2009年3月~2009年5月門診終止妊娠早孕婦女100例,分為兩組。芬太尼組50例,利多卡因組50例。比較兩組宮旁阻滯麻醉鎮痛效果及人流綜合征發生率。結果:芬太尼組的鎮痛效果明顯優于利多卡因組,人流綜合征的發生率明顯低于利多卡因組。結論:芬太尼宮旁阻滯麻醉具有鎮痛效果明顯，人流綜合征發生率低等優點，優于利多卡因麻醉效果。
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。
目的：觀察利多卡因宮旁阻滯聯合宮腔灌注在人流術中鎮痛的效果。方法:收集我院2005年1～2月門診終止妊娠的早孕婦女共94例并分為兩組:單純宮旁阻滯組（簡稱單純組）35例，宮旁阻滯聯合宮腔灌注（簡稱聯合組）59例。比較兩種利多卡因局麻方式的效果。結果:（1)兩組的止痛效果無明顯差異(P=0.893);(2)聯合組對宮頸的松弛作用優于宮旁阻滯(Ｐ=0.000);(3)聯合組較多病例出現眩暈、耳鳴等副反應。結論:與單純宮旁阻滯相比，宮旁阻滯聯合宮腔灌注并無明顯優勢。