静脉输注利多卡因对妇科腹腔镜日间手术患者围术期镇痛及加速康复的影响

Effect of intravenous infusion of Lidocaine on perioperative analgesia and enhanced recovery after surgery of patients undergoing laparoscopic daytime surgery

目的探讨利多卡因术中持续静脉输注对妇科腹腔镜日间手术患者围术期镇痛及快速康复的影响。方法选择全麻下行妇科腹腔镜日间手术患者80例,随机分为研究组和对照组,每组40例。研究组于麻醉诱导时静脉输注利多卡因1.5 mg/kg,随后以1.5 mg/(kg·h)持续输注至手术结束;对照组给予等容量生理盐水。记录术中丙泊酚和阿片类药物用量,拔管时间,离开麻醉后恢复室时、术后6 h、出院时的Ramsay镇静评分和视觉模拟评分法评分,术后首次排气时间,及不良反应的发生情况。结果与对照组比较,研究组瑞芬太尼的用量更小,离开麻醉后恢复室时、术后6 h的静息和咳嗽VAS评分更低,拔管时间与术后首次排气时间更早,差异均有统计学意义(均P<0.05)。结论利多卡因术中静脉输注用于妇科腹腔镜日间手术是安全的,能增强术中、术后镇痛,缩短拔管时间,促进术后胃肠功能恢复。

Objective To explore the effect of continuous intravenous infusion of Lidocaine on perioperative analgesia and enhanced recovery after surgery of patients undergoing laparoscopic daytime surgery.Methods 80 patients undergoing gynecological laparoscopic daytime surgery under general anesthesia were randomly divided into the research group and the control group,with 40 cases in each.Lidocaine 1.5 mg/kg was intravenously injected during anesthesia induction in the research group,and then continuously infused at 1.5 mg/(kg·h)until the end of the operation.The control group was given an equal volume of normal saline.The dosage of propofol and opioids,extubation time,Ramsay and visual analogue scale(VAS)scores at leaving postanesthesia chae unit,6 h after operation and discharge were all recorded,and the first postoperative exhaust time and the incidence of adverse reaction were also recorded.Results Compared with the control group,the dosage of remifentanil was lower,the rest and cough VAS scores at leaving postanesthesia chae unit and 6 h after operation were lower,the extubation time and the first postoperative intestinal exhaust time were earlier in the research group(P<0.05).Conclusion Intravenous infusion of Lidocaine during operation is safe for laparoscopic daytime operation,as it can enhance the analgesic effect during and after operation,shorten the extubation time and promote the recovery of the gastrointestinal function.