七氟烷复合小剂量利多卡因麻醉对老年人食管癌术后镇痛和肠功能恢复的影响

The effects of sevoflurane compound the small dose of lidocaine on postoperative analgesia and intestinal function recovery after esophageal cancer operation in elderly patients

目的观察七氟烷复合小剂量利多卡因麻醉对老年人食管癌术后镇痛和肠功能恢复的影响。方法2009年9月—2010年3月行胸部食管癌手术患者60例,随机分为利多卡因组(L组)和生理盐水对照组(C组),2组术中均采用七氟烷吸入为主的麻醉方法,L组于麻醉诱导期静脉注射利多卡因1.0 mg/kg,随后以1.5 mg·kg^(-1)·h^(-1)的速度持续静脉泵入至手术后12 h,C组输注同量的生理盐水。记录手术后12 h及24 h的吗啡用量、术后视觉模拟疼痛评分(VAS)以及手术后第1次肛门排气和排便时间。结果与C组比较,L组术后主动运动和咳嗽时的疼痛评分降低,手术后12 h、24 h吗啡用量减少,手术后第1次肛门排气和排便时间缩短,2组比较差异有统计学意义(P<0.05)。结论七氟烷复合小剂量利多卡因麻醉可显著降低老年人食管癌手术后镇痛药的用量,缓解手术后疼痛,加快手术后肠功能的恢复。

Objective The study was aimed to explore the effects of sevoflurane compound small dose of lidocaine on postoperative analgesia and intestinal function recovery after esophageal cancer operation in elderly patients. Methods Sixty cases with esophageal cancer from September 2009 to March 2010 were divided into lidocaine group and saline group randomly.Both two groups received intraoperative sevoflurane based anesthesia,followed with 1.5 mg·kg^-1·h^-1 lidocaine intravenous injection at anesthesia induction phase（lidocaine group）,or same dose of saline（saline group）.The 12h and 24h post-operative morphine consumption and postoperative visual analogue pain score,as well as the time of first flatus and stool were recorded.Results In lidocaine group,the postoperative visual analogue pain socre was decreased than saline group,together with the 12h and 24h postoperative morphine consumption and the time of first flatus and stool（P〈0.05）.Conclusion It demonstrated that the sevoflurane compound small dose of lidocaine on esophageal cancer operation in elderly patients could reduce the pain after operation,and relieved the intestinal function could be quickly recovered.