局部使用利多卡因在结肠镜检查中的应用

Local application of lidocaine in colonoscopy

目的探讨在结肠镜检查中局部使用利多卡因的解痉作用。方法 60例拟行结肠内镜下切除治疗的患者,采用单中心随机、双盲、阳性平行对照法分成利多卡因组(LID组)与薄荷水组(PEP组),每组30例。LID组局部喷洒2%的利多卡因溶液,PEP组局部喷洒薄荷油溶液。比较两组患者解痉潜伏期、5 min内解痉作用持续时间,以及解痉作用、肠痉挛反弹发生情况。结果 LID组的潜伏期短于PEP组,5 min内解痉作用持续时间长于PEP组,差异有统计学意义(P<0.05)。两组解痉作用比较差异无统计学意义(P>0.05);LID组痉挛反弹发生率10.0%(3/30)明显低于PEP组的43.3%(13/30),差异有统计学意义(P<0.05)。结论利多卡因与薄荷醇的抗痉挛作用疗效相当,而利多卡因可以显著的降低痉挛反弹的发生率。

Objective To investigate the effect of local application of lidocaine in colonoscopy. Methods A total of 60 patients scheduled to undergo endoscopic colon resection were divided by single-center, randomized, double-blind, positive parallel method into lidocaine group（ LID group） and peppermint water group（PEP group）, with 30 cases in each group. The LID group was sprayed with 2% lidocaine solution, and the PEP group was sprayed with peppermint oil solution. The spasmodic incubation period, duration of spasmodic action in 5 min, spasmodic effect and the incidence of spastic rebound were compared between the two groups. Results The LID group had shorter incubation period than PEP group, and longer duration of spasmodic action in 5 min than PEP group. Their difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in spasmodic effect（P〉0.05）. The LID group had obviously lower incidence of spastic rebound as 10.0%（3/30） than 43.3%（13/30） in PEP group, and the difference was statistically significant（P〈0.05）. Conclusion Lidocaine and menthol have similar antispasmodic effects, while lidocaine can significantly reduce the incidence of spastic rebound.