静脉注射小剂量利多卡因在无痛肠镜检查的应用

Application of intravenous low-dose lidocaine in painless colonoscopy

目的观察小剂量利多卡因静脉注射在无痛肠镜检查的应用效果。方法行无痛肠镜检查患者77例随机分为两组,均采用丙泊酚+雷米芬太尼静脉麻醉。L组39例,2%利多卡因1.5mg/kg静脉推注,并以4mg·kg^(-1)·h^(-1)持续泵注至检查结束;C组38例,给予等量生理盐水作为对照。于患者入恢复室即刻、15min及30min评估VAS疼痛评分。记录麻醉药物使用量,观察不良反应发生情况。结果与C组比较,L组丙泊酚总用量及追加丙泊酚总量较少(P<0.01)。检查过程中,L组低血压、心动过缓及SpO_(2)<95%的发生率低于C组(P<0.05)。与C组比较,L组患者入恢复室后的VAS疼痛评分较低(P<0.01)。结论在无痛肠镜检查中,复合应用小剂量利多卡因静脉输注可以减少丙泊酚用量,减轻术后疼痛,降低不良反应发生率。

Objective To observe the application efficacy of intravenous low-dose lidocaine in painless colonoscopy.Methods A total of 77patients undergoing painless colonoscopy were randomly divided into two groups.The intravenous anesthesia with propofol and remifentanil was performed in both groups.During colonoscopy,2%lidocaine 1.5 mg/kg was injected intravenously,which was followed by 4mg·kg^(-1)·h^(-1) pumping until the end of operation in group L(39cases).The same amount of normal saline was used in group C(38cases)as the control.VAS pain score was evaluated at the time points of entering PACU(T1),at 15minutes(T2)and 30minutes(T3)during PACU stay.The consumption of anesthetics was calculated and relevant adverse responses were observed.Results Compared with group C,group L had less consumption of propofol and additional propofol(P<0.01).During operation,the percentages of the patients with hypotension,bradycardia and SpO_(2)<95%in group L were lower than those in group C(P<0.05).The VAS scores at T1-T3were less in group L than those in group C(P<0.01).Conclusion In the painless colonoscopy,intravenously combined use of low-dose lidocaine can decrease the propofol consumption,attenuate the postoperative pain,and reduce the incidence of adverse responses.