摘要
目的观察利多卡因与地佐辛对腹腔镜胆囊切除术(LC)患者瑞芬太尼麻醉痛觉过敏的影响。方法选择全身麻醉下行LC手术患者66例,将入选的年龄18~64岁、ASA分级Ⅰ~Ⅱ级患者,采用随机数字表法分为3组:利多卡因组(L组)、地佐辛组(D组)和对照组(C组),L组于手术结束前10min时静脉推注负荷剂量1.5mg/kg利多卡因,随后以1.5mg/(kg·h-1)持续输注直至手术结束,D组于手术结束前10min静脉推注地佐辛10mg,C组静脉推注等量的生理盐水。记录术中丙泊酚、瑞芬太尼的用量,手术时间,拔管时间,术后15min、1h、6h、12h、24hVAS评分、术后24h镇痛补救次数及氟比洛芬酯的使用总量,并记录术后不良反应的发生情况及出院时间。结果最终完成研究病例63例。D组、L组术后15min、1hVAS评分、术后24h镇痛补救次数及氟比洛芬酯的使用总量均低于C组,差异有统计学意义(P<0.05);与D组比较,L组术后15min、1hVAS评分降低,差异有统计学意义(P<0.05),但VAS评分均小于3分,且两组患者术后24h镇痛补救次数及氟比洛芬酯使用的总量差异无统计学意义(P>0.05);三组患者术后恶心呕吐、头晕、呼吸抑制及术后寒战发生率差异无统计学意义(P>0.05)。结论瑞芬太尼麻醉下行LC手术患者使用利多卡因与地佐辛可减轻痛觉过敏同时不增加术后不良反应的发生,利多卡因的效果是否强于地佐辛需要更大样本的研究。
Objective To observe the effect of lidocaine and dizocine on anaesthesia hyperalgesia induced by remifentanil in patients undergoing laparoscopic cholecystectomy(LC). Methods Sixty-six patients underwent LC by general anesthesia were selected.The enrolled patients aged 18~64 years and in ASA grade I^II were divided into three groups by random number table method:lidocaine group(group L),dizocine group(group D)and control group(group C).Ten minutes before the end of the operation,patients in group L were injected intravenously with a loading dose of 1.5 mg/kg lidocaine,followed by continuous infusion with a dose of 1.5 mg/(kg·h-1)until the end of the operation.Patients in group D were intravenously injected with 10 mg of dizocine ten minutes before the end of surgery,and patients in group C were intravenously injected with the same amount of saline.The intraoperative dosage of propofol and remifentanil,the operative time,extubation time,VAS score at 15 minutes,1 h,6 h,12 hand 24 hafter the operation,analgesia relief times at 24 hafter surgery and the total amount of flurbiprofen axetil were recorded,and the occurrence of postoperative adverse reactions and discharge time were recorded. Results Sixty-three cases completed the study finally.VAS scores at 15 min and 1 hafter surgery,number of analgesic remedies 24 hafter surgery and total amount of flurbiprofen axetil use in the group D and group L were all lower than those in the group C,and the differences were statistically significant(P <0.05).Compared with group D,VAS scores at 15 min and 1 hafter surgery in group L were decreased,with statistically significant difference(P <0.05),but VAS scores were all less than 3 points,and there was no statistically significant difference in number of analgesia remedies 24 hafter surgery and total amount of flurbiprofen axetil use between the two groups(P >0.05).There was no significant difference in incidence of postoperative nausea and vomiting,dizziness,respiratory depression and postoperative shivering among the three g
作者
陈伟
王鸿志
陈永权
Chen Wei;Wang Hongzhi;Chen Yongquan(Department of Anesthesiology,Yijishan Hospital of Wannan Medical College,Wuhu 241000,Anhui,China)
出处
《右江民族医学院学报》
2020年第1期72-75,共4页
Journal of Youjiang Medical University for Nationalities
