小剂量利多卡因对术后镇痛治疗中静脉炎的预防作用

Preventive effect of small dose lidocaine on phlebitis during postoperative analgesia

目的 观察小剂量利多卡因在术后患者自控镇痛治疗中对静脉炎的预防作用 .方法 选择行术后镇痛治疗的腹部手术后患者 12 0名 ,随机分为 4组 ,每组 30名 . 4组患者的镇痛配方如下 : 组 ,芬太尼 1.5 mg+氟哌啶 5 .0 mg; 组 ,芬太尼 2 m g+氟哌啶 5 mg; 组 ,芬太尼 2 mg+氟哌啶 5 mg+利多卡因 10 0 mg; 组 ,芬太尼 2 mg+氟哌啶 5 mg+利多卡因 2 0 0 mg.各组均用 9g· L- 1生理盐水稀释至 80 m L,选用进口一次性静脉镇痛泵 ,0 .5 m L· h- 1 .在镇痛治疗过程中观察各组不同配方的患者静息镇痛评分、静脉炎发生率和静脉炎程度评分、恶心及呕吐反应 .结果 各组镇痛评分和恶心、呕吐发生率基本相似 ,但静脉炎的发生率及静脉炎程度评分后两组明显低于前两组 (P<0 .0 5 ) .

AIM To evaluate preventive effect of small dose lidocaine on phlebitis during postoperative analgesia. METHODS 120 patients undergoing postoperative patient controlled analgesia were randomly divided into four groups ( n =30 in each group). Group Ⅰ fentanyl 1.5 mg+ droperidol 5.0 mg; Group Ⅱ fentanyl 2 mg+ droperidol 5 mg; Group Ⅲ fentanyl 2 mg+ droperidol 5 mg + lidocaine 100mg and Group Ⅳ fentanyl 2 mg+ droperidol 5 mg + lidocaine 200 mg. The drugs in all the groups were diluted in 9 g· L -1 saline 80 mL with a disposable perfusion pump. The perfusion velocity was 0.5 mL·h -1 . The static analgesic scores, incidence of nausea and vomiting, incidence and severe score of phlebitis were recorded. RESULTS The static analgesic score and the incidence of nausea and vomiting were similar for all the groups. But the incidence of phlebitis and its severe score in Groups Ⅲ and Ⅳ were significantly lower than those of Group Ⅰ and Ⅱ ( P <0.05). CONCLUSION A small dose of lidocaine added in analgesics for postoperative analgesia could prevent the incidence of phlebitis.