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 explore the effect of restrictive fluid administration on elderly patients with colorectal cancer in fasttrack.Methods From January 2008 to January 2009, the elderly patients (≥60 years old) diagnosed definitely as colorectal cancer were analyzed retrospectively, the clinical effects on post-operative early rehabilitation were studied and the difference between restrictive fluid regimen and tradition fluid regimen was compared. Results The difference of overall incidence of post-operative complications was statistically significant between the two groups (Plt;0.05). The incidences of anastomotic leakage and pulmonary infection of fluid restriction group were lower than those of tradition therapy group (Plt;0.05). The time of vent to normal, defecation to normal and postoperative first eating of fluid restriction group was shorter than those of tradition therapy group, the difference was statistically significant (Plt;0.05). Comparing the biochemical indicators, the difference of preoperative GLU 〔（6.70±2.93） mmol/L vs. （6.33±3.95） mmol/L〕, BUN 〔(5.84±2.03) mmol/L vs. （7.32±10.83） mmol/L〕and CREA 〔(76.19±19.85) μmol/L vs. （85.36±38.02） μmol/L)〕 was statistically significant (Plt;0.05), but the difference of postoperative results had no statistical significance. Conclusion Restrictive fluid regimen can reduce the incidence of common complications after colorectal surgery for elderly patients, and have a certain promoter action to the early rehabilitation after rectal surgery.