摘要
目的确定预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的半数有效剂量(ED_(50))。方法选取择期全麻手术患者[美国麻醉医师协会(ASA)分别Ⅰ或Ⅱ级]。在患者使用丙泊酚中/长链脂肪乳之前,预先静脉注射利多卡因,初始剂量为0.5 mg/kg瘦体质量(LBW)。根据注射痛程度采用Dixon序贯法行利多卡因剂量调整。记录注射痛情况及不良反应发生情况。计算利多卡因的ED_(50)及95%CI。记录麻醉后监测治疗室(PACU)内患者对注射痛的记忆情况并行视觉模拟评分量表(VAS)评估。结果共30例患者完成试验,其中有效止痛患者19例,无效患者11例。预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的ED_(50)为0.306 mg/kg(95%CI:0.262~0.357 mg/kg)LBW。90.9%发生注射痛的患者在PACU内对注射痛有记忆,VAS评分为(2.8±1.8)分。结论预先静脉注射利多卡因0.306 mg/kg LBW可有效预防50.0%的择期全麻手术患者丙泊酚中/长链脂肪乳注射痛,且无不良反应。
Objective To ensure the median effective dose(ED_(50)) of intravenous lidocaine in advance in preventing propofol medium-/long-chain triglyceride emulsion injection pain. Methods Patients for elective surgery undergoing general anesthesia [American Society of Anesthesiologists(ASA) grade Ⅰ or Ⅱ]were selected. Lidocaine was administered intravenously prior to propofol medium-/long-chain triglyceride at an initial dose of 0.5 mg/kg lean body mass(LBW). The dose of lidocaine was adjusted by Dixon sequential method according to injection pain. Injection pain and adverse reactions were recorded. The ED_(50)and 95%CI of lidocaine were calculated. Patients′memory of injection pain in postanesthesia care unit(PACU) was recorded and Visual Analogue Scale(VAS) was evaluated. Results A total of 30 patients completed the trial, including 19 patients with effective pain relief and 11 patients with ineffective pain relief. The ED_(50)of lidocaine in advance to prevent propofol medium-/long-chain triglyceride emulsion injection pain was 0.306 mg/kg(95%CI, 0.262 to 0.357 mg/kg) LBW. In PACU, 90.9% of the pain-experienced patients had memory of injection pain, and VAS score was(2.8±1.8). Conclusion Prophylactic intravenous lidocaine for 0.306 mg/kg LBW could effectively prevent propofol medium-/long-chain triglyceride emulsion injection pain in 50.0% of patients for elective surgery undergoing general anesthesia without adverse reactions occurred.
作者
谭潮
吴浩
于乐洋
严诗婷
王莹
田顺平
周炜
眭伟
张转
TAN Chao;WU Hao;YU Leyang;YAN Shiting;WANG Ying;TIAN Shunping;ZHOU Wei;SUI Wei;ZHANG Zhuan(Department of Anesthesiology,Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225012;Graduate School,Dalian Medical University,Dalian,Liaoning,116000)
出处
《实用临床医药杂志》
CAS
2022年第2期132-136,共5页
Journal of Clinical Medicine in Practice
基金
扬州大学附属医院院级课题重点资助项目(YZYY2017-07)。
关键词
利多卡因
丙泊酚
中/长链脂肪乳
注射痛
半数有效剂量
lidocaine
propofol
medium-/long-chain triglyceride emulsion
injection pain
median effective dose
