摘要
目的探讨静脉丙泊酚复合利多卡因镇静在经内镜逆行胰胆管造影术(ERCP)取石术中的应用效果。方法选取择期在海军军医大学第三附属医院行ERCP取石术的胆总管结石患者40例,均为男性。采用随机数字表法将患者分为丙泊酚+利多卡因组(A组)和丙泊酚组(B组),每组20例。A组均先静脉泵注利多卡因1.5 mg·kg-1,然后按照2 mg·kg-1·h-1持续泵注。B组不予利多卡因,单纯丙泊酚静脉麻醉。记录并比较2组术中丙泊酚用量,术中氧饱和度低于90%、低血压、心律失常发生率,苏醒时间和术后1 h VAS评分。结果A组术中丙泊酚用量少于B组[(97.4±16.3)mL比(119.7±21.6)mL,P<0.05];A组术后1 h VAS评分低于B组[(1.1±1.41)分比(2.25±1.65)分,P<0.05];A组低血压发生率低于B组[10%(2/20)比45%(9/20),P<0.05];2组低氧血症及心律失常发生率比较差异均无统计学意义(P>0.05)。结论术中持续输注利多卡因可以减少术中丙泊酚用量,并且不会影响内镜医生操作。静脉泵注利多卡因还能够减轻ERCP取石术后疼痛,降低术中低血压发生率。
Objective To study the efficacy of intravenous sedation with propofol and lidocaine in endoscopic retrograde cholangiopancreatography(ERCP)lithotomy.Methods Forty male patients scheduled for ERCP in the Third Affiliated Hospital of the Naval Medical University were randomly divided into two groups,with 20 patients in each group.The propofol+lidocaine group(group A)was given intravenous infusion of 1.5 mg·kg-1 lidocaine,followed by continuous infusion of 2 mg·kg-1·h-1 lidocaine.The propofol group(group B)only received intravenous propofol anesthesia.Intraoperative propofol dosage,incidence of oxygen saturation less than 90%,hypotension and arrhythmia,awakening time,and visual analog scale(VAS)score at 1 hour postoperatively were compared between the two groups.Results Compared with group B,the combination of propofol and lidocaine significantly decreased intraoperative propofol dosage((97.4±16.3)mL vs(119.7±21.6)mL),1-hour postoperative VAS score(1.1±1.41 vs 2.25±1.65),and incidence of hypotension(10%vs 45%)(P<0.05).There was no significant difference in the incidence of hypoxemia and arrhythmia between the two groups.Conclusion Intraoperative continuous lidocaine infusion can reduce propofol dosage without affecting the endoscopic operation.In addition,intravenous infusion of lidocaine can relieve the pain after ERCP lithotomy and decrease the incidence of intraoperative hypotension.
作者
朱成成
陆智杰
ZHU Cheng-cheng;LU Zhi-jie(Grade 2017,Department of Anesthesiology,Medical College of Nanchang University,Nanchang 330006,China;Department of Anesthesiology,the Third Affiliated Hospital of the Naval Medical University,Shanghai 200082,China)
出处
《南昌大学学报（医学版）》
CAS
2020年第5期61-63,共3页
Journal of Nanchang University：Medical Sciences
关键词
胆总管结石
经内镜逆行胰胆管造影术
利多卡因
持续输注
静脉麻醉
镇静
丙泊酚
choledo cholith
endoscopic retrograde cholangiopancreatography
lidocaine
continuous infusion
intravenous anesthesia
sedation
propofol
