摘要
目的探讨麻醉中静脉输注利多卡因对腹腔镜胆囊切除术患者术后快速康复的影响。方法本研究为前瞻性随机对照研究，选取2016年2至8月温州医科大学附属义乌医院60例拟在全麻下行腹腔镜胆囊切除术患者，采用随机数字表法分为对照组（n＝30）和利多卡因组（n＝30）。利多卡因组患者诱导时注射利多卡因1.5 mg/kg后以2.0 mg·kg－1·h－1速度持续输注至术毕；对照组注射等容量生理盐水。两组患者麻醉诱导均为静注咪唑安定0.03 mg/kg、舒芬太尼0.2 μg/kg、丙泊酚2.0 mg/kg和顺苯磺酸阿曲库铵0.2 mg/kg，丙泊酚0.05～0.20 mg·kg－1·min－1、瑞芬太尼0.1～0.5 μg·kg－1·min－1喉罩维持麻醉使脑电双频指数（BIS）在40～60。记录麻醉诱导前、喉罩置入前、喉罩置入后即刻、手术开始后30 min、苏醒时的BIS值、心率（HR）、平均动脉压（MAP）；观察术后即刻、入麻醉后恢复室（PACU）30 min以及术后2、6、12、24 h疼痛视觉模拟评分（VAS）；记录PACU滞留时间、术后下床活动时间、首次肠道排气时间及出院时间；统计两组术中丙泊酚、瑞芬太尼用量、术后VAS〉3分时追加舒芬太尼（5 μg/次）的频率及术后恶心、呕吐不良反应的发生率，采用简易恢复质量评分量表（QoR-9）评估患者术后满意度。结果利多卡因组在喉罩置入前后的BIS值分别为50.50±3.47、54.63±1.25，低于对照组的54.30±4.78、55.80±2.33，差异有统计学意义（t＝3.542、2.423，均P〈0.05）。利多卡因组术后即刻、入PACU后30 min以及术后2、6、12 h的VAS分别为（2.76±0.97）、（2.37±0.93）、（2.10±1.12）、（1.76±0.97）、（1.20±0.76）分，低于对照组的（3.83±1.34）、（3.27±1.26）、（3.06±1.20）、（2.63±0.88）、（1.90±0.84）分，差异均有统计学意义（t＝3.528、3.154、3.217、3.603、3.372，均P〈0.05）。利多卡因组术后即刻、PACU期间追加舒芬�
Objective To investigate the effect of intravenous infusion with lidoeaine on rapid recovery of laparoscopic cholecystectomy. Methods This study was a prospective randomized controlled triM. From February to August 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 60 patients scheduled for laparoscopic cholecystectomy under general anesthesia were involved and randomly divided into control group （ n = 30） and lidocaine group （ n = 30）. Patients in lidocaine group received lidocaine 1.5 mg/kg intravenously before induction and followed by 2. 0 mg· kg-1 · h-1 to the end of surgery. Patients in control group received equal volumes of saline intravenously. Anesthesia induction in both groups were given intravenous midazolam 0. 03 mg/kg, sufentanil 0. 2 μg/kg, propofol 2. 0 mg/kg and cisatracuium 0. 2 mg/kg. Anesthesia was maintained with propofol 0.05 -0. 20 mg · kg-1· min-1 and remifentanil 0. 1- 0. 5 μg · kg-1· min-1 for laryngeal mask airway which bispectral index （BIS） value maintained at 40 -60. BIS, heart rate（HR） and mean arterial pressure（MAP） were recorded before anesthesia induction, before and immediately after laryngeal mask implantation, intraoperative 30 min and anesthesia awake. Pain scores were assessed using visual analogue scales （VAS） at postoperation immediately, 30 min during postanesthesia care unit （PACU）, 2, 6, 12, and 24 h after surgery. The time of PACU retention, postoperative ambulation, first intestine venting and discharge were recorded. The dosage of propofol and remifentanil, the frequency of sufentanil used, the incidence of postoperative nausea and vomiting were also recorded. Patient satisfaction was evaluated by using Simple Restoration Quality Score （QoR-9）. Results BIS values before and after laryngeal mask implantation in lidocaine group were 50. 50 ± 3.47 and 54. 63 ± 1.25 respectively, which was lower than those in control group （54. 30 ± 4. 78, 55.80 ± 2. 33 ; t = 3. 542, 2. 423, all P 〈 0. 05）. The VAS score at
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第12期934-939,共6页
National Medical Journal of China
关键词
注射
静脉内
利多卡因
手术后期间
康复
胆囊切除术
腹腔镜
Injections, intravenous
Lidocaine
Postoperative period
Rehabilitation
Cholecystectomy, laparoscopie
