不同浓度利多卡因星状神经节阻滞的效果

Effectiveness of stellate ganglion block with different concentrations of lidocaine

目的比较不同浓度利多卡因行星状神经节阻滞时起效时间、维持时间及不良反应。方法拟行星状神经节阻滞治疗的患者240例，年龄37～76岁，ASAⅠ或Ⅱ级，随机分为3组（n=80）：0．6％利多卡因组（A组）、0．8％利多卡因组（B组）及1％利多卡因组（c组）。由疼痛科同一医师采用胸锁乳突肌后路法行单侧星状神经节阻滞。记录起效时间、维持时间和不良反应发生情况。结果240例患者均发生霍纳综合征。三组起效时间比较差异无统计学意义（P〉0．05）；与A组比较，B组和c组维持时间延长（P〈0．05）；与B组比较，C组维持时间延长（P〈0．05）；三组间喉返神经阻滞、臂丛神经阻滞、局麻药中毒和一过性意识丧失等不良反应发生率比较差异无统计学意义（P〉0．05）。结论采用0．6％利多卡因、0．8％利多卡因组和1％利多卡因行星状神经节阻滞，虽然维持时间不同，但均迅速起效，并达到治疗目的，因此建议采用低浓度局麻药即0．6％利多卡因。

Objective To compare the onset time, duration and adverse effects of stellate ganglion block （SGB） with different concentrations of lidocaine .Methods Two hundred and forty ASA Ⅰ orⅡ patients （97 male, 143 female） aged 37-76 yr weighing 48-79 kg were randomly divided into 3 groups （n = 80 each） ： group A, B and C received unilateral SGB with 8 ml of 0.6% , 0.8% and 1.0% lidocaine respectively. Unilateral SGB was performed by the same anesthesiologist in all patients. Successful SGB was verified by Homer＇s syndrome. The onset time, duration and adverse effects were recorded. Results Homer＇s syndrome was observed in all patients. There was no significant difference in onset time among the 3 groups. The duration of action was significantly longer in group B and C than in group A and in group C than in group B. There was no significant difference in the adverse effects including recurrent laryngeal nerve block, brachial plexus block, local anesthetic intoxication and transient loss of consciousness among the 3 groups. Conclusion SGB can be induced with either 0.6% , 0. 8 % or 1.0% lidocaine with comparable effectiveness. We suggest using lower concentration of lidocaine.