硝酸甘油和利多卡因混合液行局部麻醉预防桡动脉痉挛的临床观察

Clinical Observation on Local Anesthesia of Nitroglycerin and Lidocaine on Prevention of Radial Artery Spasm

目的:对利多卡因、硝酸甘油混合液实施局部麻醉给桡动脉痉挛(RAS)带来的预防成效进行观察。方法:回顾性分析我院2007年2月至2010年10月经桡动脉冠脉造影(CAG)和介入治疗(PCI)的冠心病患者476例分2组,试验组238例,均采用利多卡因、硝酸甘油混合液进行局部麻醉,该混合液是由从5mg的硝酸甘油注射液再加入50mL生理盐水中选取出来的5mL+5mL的2%利多卡因注射液,配1-2mL的麻醉混合液进行局部浸润;对照组238例,采用1-2mL的浓度为1%的利多卡因注射液进行局麻;当对照组与试验组实施穿刺成功之后,将300ug硝酸甘油、30mg利多卡因、3000iu普通肝素钠经鞘管注入;对手术中RAS发生几率进行观察。结果:试验组RAS 8例(3.4%),对照组RAS 24例(10.1%),两者比较有统计学意义(P<0.05)。结论:局部麻醉时,选取利多卡因、硝酸甘油混合注射液,可以大大降低桡动脉痉挛的发生几率,使得手术成功的几率大幅度增加。

Objective： To observe the effects of nitroglycerin and lidocaine on prevention of radial artery spasm （RAS}. Method：476 patients with coronary heart disease treated with CAG and PCI from Februar- y2007 to October 2010, were analyzed retrospectively and divided into 2 groups, the experiment group of 238 cases were given local anesthesia used local anesthesia of nitroglycerin and lidocaineby （ 2% lidocaine injec- tion 5mL＋ Nitroglycerin injection 5rag in 50mL saline extraction 5mL}. Local infiltration anaesthesia dosage was 1-2mL. After successful puncture of 2 groups, 30mg lidocaine, 300ug nitroglycerin and 3000iu heparin sodium were injected through sheath tube. Observing the intraoperative incidence rate of RAS. Result：There were 8 cases of RAS in the experiment group{3.4% }, and 24 cases of RAS in the control group（ 10.1% }, which had statistical significance { P〈0.05 }. Conclusion： Local anesthesia of nitroglycerin and lidocaine can prevent radial artery spasm effectively and increase the successful rate of operation.