静脉输注利多卡因对腹部大手术炎症反应的影响

Effects of intravenous infusion of lidocaine on inflammatory reaction on major abdominal surgery

目的探讨静脉输注利多卡因对腹部大手术炎症反应的影响。方法72名择期行腹部大手术患者随机分为2组,L组为静脉输注利多卡因组(诱导期静脉注射利多卡因1.5 mg/kg,随后以1.5 mg/(kg.h)的速度持续静脉输注至手术后12 h),C组为生理盐水对照组(输注同量的生理盐水)。分别于诱导前、切口缝合完毕、手术后6 h、手术后3 d采血分别检测IL-1β、IL-6、IL-8、IL-10和TNF-α水平。记录手术后视觉模拟疼痛评分及吗啡的用量。结果静脉注射利多卡因可减少手术引起IL-6及IL-8的增高,而对TNF-α、IL-1β和IL-10的变化无明显影响。利多卡因可显著降低手术后主动运动和咳嗽时的疼痛评分,并减少手术后吗啡的用量。结论围手术期静脉注射小剂量利多卡因可减弱腹部大手术所致的过度炎症反应,有利于手术后的康复。

Gbjective It is to investigate the influence of of intravenous infusion of lidocaine on inflammatory reaction in major abdominal surgery. Methods 72 patients scheduled to undergo major abdominal surgery were randomly divided into group L （receiving intravenous lidocaine, bolus injection of 1.5 mg/kg lidocaine at induction of anesthesia, followed by a continuous infusion of 1.5 mg/（kg· h） intraoperatively and for 12 h postoperatively） or group C （an equal volume of physiological saline）. Plasma levels of IL- 1β, IL- 6, IL- 8, IL- 10, and TNF- α were determined. Postoperative pain scores and morphine consumption were measured. Results Lidocaine could significantly attenuate the enhancement of plasma levels of IL - 6 and IL - 8, but could not influence the plasma levels of TNF - α, IL - 1β and IL - 10. Lidocaine could significantly reduce opioid consumption and postoperative pain scores. Conclusion Perioperative administration of low doses of intravenous iidoeaine reduces inflammatory reaction and has a clinically relevant beneficial effect on major abdominal surgery.