不同剂量利多卡因对改良电休克血流动力学的影响

The effect of different doses of lidocaine on hemodynamic by modified electroconvulsive therap

目的:探讨不同剂量利多卡因对改良电休克血流动力学的影响。方法:选择住院的精神病患者46例。按年龄分层随机分五组,分别预注等量生理盐水(A组)和利2%多卡因0.5 mg/kg(B组),0.75 mg/kg(C组),1.0 mg/kg(D组),1.25 mg/kg(E组)。之后依次静推丙泊酚1.5 mg/kg,氯化琥珀胆碱0.8 mg/kg,电休克治疗,记录各组患者麻醉前(T0),改良电休克后1(T1)分钟,3分钟(T2),5分钟(T3)的平均动脉压、心率、血氧饱和度。结果:不同时间点患者的平均动脉压、心率比较,差异有统计学意义(P<0.01);时间与处理方法的交互作用比较,差异无统计学意义(P>0.05),即不同处理方法时间趋势相同;不同的处理方法对平均动脉压、心率、血氧饱和度的影响比较,差异无统计学意义(P>0.05)。结论:静脉预注利多卡因不能够改善电休克治疗中血流动力学的剧烈波动,不推存将利多卡因用于预防改良电休克引起的应激反应。

Objective To investigate the effect of different doses of lidocaine on hemodynamic by modified electroconvulsive therap（MECT）.Method 46 patients were selected and randomly assigned into five groups,Forty -six patients who need ECT were intravenously administered different doses of lidocaine before administering propofol （0.0 mg/kg,0.5 mg/kg,0.75 mg/kg,1.0 mg/kg,1.25 mg/kg）randomly at MECT sessions,propofol 1.5 mg/kg and succinylcholine 0.8 mg/kg before modified electroconvulsive therap,mean arterial pressure （MAP）,heart rate （HR）and SPO2 were measured before anaesthesia （T0 ）,at 1 min （T1 ）、3 min （T2 ）and 5 min （T3 ）after MECT.Results MAP and HR in patients with different time points were statistically significant（P 〈0.01）,The interaction between time and treatment method was not statistically significant（P 〉0.05）,Effects of different treatments on MAP,HR,SpO2 was not statistically significant（P 〉0.05）.Conclusion Intravenous infusion of lidocaine is not able to improve the hemodynamic fluctuations in the treatment of electric shock,Don′t push the deposit will be lidocaine for stress response induced by MECT prevention.