【摘要】 目的观察静脉应用利多卡因在丙泊酚全身麻醉诱导时对顺式阿曲库铵起效时间以及血流动力学的影响。方法选择美国麻醉医师学会(ASA)分级Ⅰ~Ⅱ级,行择期手术的全身麻醉患者40例,随机分成利多卡因(L)组和0.9%氯化钠溶液(C)组,每组均为20例。L、C组分别在丙泊酚麻醉诱导后脑电双频指数(BIS)值达到60时,静脉注射1 mg/kg利多卡因或相同容量的0.9%氯化钠溶液,1 min内注射完毕,即刻每例患者静脉注射0.15 mg/kg顺式阿曲库铵。记录肌松起效时间,以及麻醉诱导前、诱导后及气管插管后患者的平均动脉压(MAP)和心率(HR)。结果 L组的顺式阿曲库铵的起效时间为(188.6±17.4)s,显著短于C组的(207.1±20.6)s(P<0.05)。气管插管后,L组的HR归一化值(即刻HR测量值/HR基础值)、MAP归一化值(即刻MAP测量值/MAP基础值)均显著小于C组(P值分别<0.05、0.01)。结论静脉应用1 mg/kg的利多卡因可明显缩短顺式阿曲库铵的起效时间,且气管插管前后血流动力学波动小。更多还原

【Abstract】 Objective To assess the effect of intravenous lidocaine on the onset time and haemodynamics of cisatracurium during propofol anesthesia.Methods Totally 40 patients with general anesthesia for elective surgery,America Society of Anesthesiologist(ASA) gradedⅠ-Ⅱ,were randomly divided into two groups(n=20): group L(lidocaine) and group C(normal saline).When propofol anesthesia induction ended and the value of bispectral index(BIS) reached 60,the same doses of 1 mg/kg lidocaine and normal saline were intravenously injected within 1 min in the group L and group C,respectively.Then 0.15 mg/kg cisatracurium was given intravenously.The onset time of muscle relaxants,mean arterial pressure(MAP),and heart rate(HR) were recorded before anesthesia induction,after anesthesia induction and after tracheal intubation.Results The onset time of cisatracurium was significantly shorter in group L than that in group C([188.6±17.4] s vs.[207.1±20.6] s,P<0.05).MAP and HR in group C were significantly higher than those in group L after tracheal intubation(P <0.05,0.01).Conclusion Intravenous injection of lidocaine(1 mg/kg) can obviously shorten the onset time of cisatracurium.There is a small haemodynamic change before and after tracheal intubation.(Shanghai Med J,2011,34: 742-746)更多还原