摘要
目的:观察利多卡因对丙泊酚麻醉诱导气管插管时血浆儿茶酚胺与脑电双频指数(BIS)变化的影响,探讨利多卡因抑制气管插管反应的机制。方法:60例患者随机分为对照组(C组)和利多卡因组(L组)。L组先静脉注射利多卡因1.5mg/kg,C组注入等量生理盐水,然后两组均静脉注射丙泊酚2mg/kg、芬太尼4μg/kg、罗库溴铵0.6mg/kg麻醉诱导后气管插管,机械通气。分别于麻醉诱导前(T0)、气管插管前(T1)、气管插管后即刻(T2)、气管插管后1min(T3)、3min(T4)记录BIS值、心率(HR)、收缩压(SP)、舒张压(DP)。并于T0、T1、T3时采集桡动脉血7mL测定肾上腺素(Ad)、去甲肾上腺素(NA)的浓度。结果:C组SP、DP、HR在气管插管后显著升高(P<0.05),而T3时血浆中Ad、NA浓度与T0比较无统计学差异(P>0.05);L组在T1-4时的BIS值显著低于C组(P<0.05),T3时血浆中Ad、NA浓度与T0及C组比较均有统计学差异(P<0.05)。结论:利多卡因能降低丙泊酚麻醉的BIS值及血浆儿茶酚胺浓度,提示其静脉给药时的镇痛镇静作用。该特性使静注利多卡因(1.5mg/kg)能抑制气管插管引起的BIS变化及减轻应激反应。
To observe the relationship between the level of catecholamine with bispectral index during endotraeheal intubation with propofol anesthesia in order to investigate the mechanism of the preventing of endotracheal in tubation response with lidocaine. METHODS： Sixty patients were randomly allocated into two groups：control group （Group C） and lidocaine group （Group L）. The patients received lido caine 1.5 mg/kg in Group L and saline in Group C before induction of anesthesia. Anesthesia was induced with propofol （2 mg/kg） and fentanyl （4 μg/kg） and tracheal intubation was facilitated with rocuronium （0.6 mg/kg） in all patients. Bispectral index （BIS）, systolic pressure（SP）, diastolic pressure（DP） and heart rate（HR） were continuously monitored and recorded before induced of anesthesia（T0 ）, preintubation（T_1 ）, immediately and 1,3 rain after intubation （T2 4）. Arterial blood samples were obtained at To, T_0 and T_3 for determination of plasma concentration of adrenaline （Ad） and noradrenaline（NA）. RESULTS：SP, DP,HR were significantly increased after intubation in Group C compared with baseline values at To （P〈0.05）,while plasma Ad and NA concentrations at T3 were of no statistic significance （P 〈 0.0S ）. Compared with Group C, BIS value at T_1 to T_4 decreased significantly in Group L（P〈0.05）. Plasma Ad and NA were lower at T3 in Group L than those in Group C and To （P〈0.05）. CONCLUSION： Lidocaine can further reduce BIS value and the plasma concen tration of catecholamines during propofol anesthesia, indicating the sedative and antinociep rive effect of intravenous Iidocaine. Lidocaine （1.5 mg/kg）can restrain the changes of BIS and reduce stress reaction caused by tracheal intubation.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2011年第12期1402-1405,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
