摘要
目的:比较硬膜外持续输注和间断注射利多卡因对麻醉平面、手术牵拉反应、恶心、血压、心率和血药浓度的影响。方法:100名下腹部手术者被随机均分成两组,初始硬膜外注射20g/L(2%)利多卡因22ml,然后持续组(CEIA)和间断组(IEIA)以15ml/h分别输入或注入。结果:对麻醉平面、手术牵拉反应、恶心的发生、心率的影响两组相似。但CEIA组收缩压和平均压的降低明显弱于IEIA组。两组间血药浓度无明显差别,但CEIA组的波动小于IEIA组。为了保证镇痛效果而使用了较大剂量的利多卡因,且血药浓度超过了中毒阈值,但没有人中毒。结论:CEIA与IEIA同是安全的麻醉方法,但CEIA有血压稳定的优点.
Objective:To compare the effects of continuous epidural infusion anesthesia (CEIA) on the spread of blockade level, incidence of nausea and visceral traction reflex, blood pressure, heart rate, and plasma concentrations of lidocaine with those of intermittent epidural injection anesthesia (IEIA). Methods:One hundred female patients who underwent lower abdominal surgery were enrolled in the study. They were randomly divided into two groups (n=50 for each) receiving initially 22 ml of 20 g/L (2%) lidocaine and followed by either CEIA or IEIA at a dose of 15 ml of 20 g/L (2%) lidocaine per hour. Results:It was demonstrated that the effects of CEIA on the spread of blockade level, heart rate, and incidence of nausea and visceral traction reflex were similar to those of IEIA. However CEIA decreased systolic and mean blood pressures less than IEIA did. The plasma concentration levels of lidocaine in CEIA were also similar to those in IEIA but fluctuated less. None of the patients in both groups showed toxic symptoms although we gave them a relative large dose of lidocaine to guarantee the analgesia, and lead to a high plasma concentration of lidocaine exceeding the authorized toxic threshold. Conclusion: CEIA is a safe and practical anesthesia method similar to IEIA, but with an advantage of more stable blood pressure.
出处
《北京医科大学学报》
CSCD
1998年第3期264-266,共3页
Journal of Peking University(Health Sciences)
关键词
利多卡因
剂量
硬膜外麻醉
滴注方法
Lidocaine/admin Anesthesia, epidural Instillation, drug/methods