摘要
目的:探讨不同剂量的利多卡因静脉滴注在顽固性带状疱疹后神经痛(post-herpetic neuralgia,PHN)病人中的临床疗效和安全性。方法:选取本院2015年6月至2016年12月期间收治的确诊为顽固性PHN病人80例,采用数字表法随机分为4组,每组20例:L1组(0.1%利多卡因100 ml持续滴注,每日1次),L2组(0.1%利多卡因100 ml持续滴注,每日2次,两次给药间隔时间为5 h),L3组(0.1%利多卡因200 ml持续滴注,每日1次),L4组(0.1%利多卡因200 ml持续滴注,每日2次,两次给药间隔时间为5 h)。每组病人静滴利多卡因速度为2.5 mg/(kg·h),持续时间7天。观察病人滴注药物后1天、3天、7天、14天、30天、60天的视觉模拟评分(visual analogue scale,VAS)和睡眠质量评分(quality of sleep,QS),并记录病人头晕头痛、嗜睡、恶心呕吐等不良反应。结果:4组病人治疗后VAS评分和QS评分均呈下降趋势,L2、L3、L4组治疗后各时间点VAS和QS与L1组比较下降更为显著(P<0.05)。L4组病人头晕头痛发生率较高,与L1、L2组比较有统计学差异(P<0.05),余不良反应四组间无统计学差异。结论:静脉滴注0.1%利多卡因200 ml/d、滴速2.5 mg/(kg·h)在顽固性PHN病人中镇痛起效迅速,效果确切,不良反应少,可在临床上推广使用。
Objective:To explore the clinical efficacy and safety of intravenous infusion of lidocaine in intractable post-herpetic neuralgia(PHN).Methods:Eighty patients with intractable PHN were randomly divided into four groups:L1(0.1%lidocaine 100 ml continuous infusion,qd);L2(0.1%lidocaine 100 ml continuous infusion twice times in a day and the interval was 5 h);L3(0.1%lidocaine 200 ml continuous infusion,qd);L4(0.1%lidocaine 200 ml continuous infusion twice times in a day and the interval was 5 h).Each group of patients was taken intravenous lidocaine 7 days with infusion rate of 2.5 mg/(kg·h).The VAS and the QS were observed at 1 day,3 days,7 days,14 days,30 days and 60 days after lidocaine infusion.The patients with dizziness and headache,drowsiness,nausea and vomiting and other adverse reactions were recorded.Results:The VAS and the QS of four groups showed a decreasing tendency after the intravenous infusion of lidocaine.In all groups,the VAS and the QS were significantly decreased after the treatment compared with the T0 point(P<0.05).In group L2、L3 and L4,the VAS and the QS after the treatment were significantly decreased compared with those in group L1(P<0.05).The incidence of dizziness and headache in group L4 was significantly higher than that in groups L1 and L2(P<0.05).Conclusion:Intravenous infusion of 0.1%lidocaine 200 ml with rate of 2.5 mg/(kg·h)in intractable PHN patients has exact clinical effect and fewer adverse reactions,could be widely used in clinical practice.
作者
代月娥
杜宇
林涛
文传兵
江平
吴莹
刘柳
DAI Yue-E;DU Yu;LIN Tao;WEN Chuan-Bing;JIANG Ping;WU Ying;LIU Liu(Department of Pain Medicine,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)
出处
《中国疼痛医学杂志》
CAS
CSCD
北大核心
2018年第7期512-516,共5页
Chinese Journal of Pain Medicine
基金
四川省卫生和计划生育委员会科研课题(16PJ460)
关键词
利多卡因
静脉滴注
镇痛
带状疱疹后神经痛
Lidocaine
Intravenous infusion
Analgesia
Post-herpetic neuralgia(PHN)
