Systemic administration of lidocaine reduces morphine requirements and postoperative pain of patients undergoing thoracic surgery after propofol-remifentanil-based anaesthesia
Systemic administration of lidocaine reduces morphine requirements and postoperative pain of patients undergoing thoracic surgery after propofol-remifentanil-based anaesthesia
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全身给予利多卡因可减少异丙酚-瑞芬太尼麻醉后接受胸外科手术患者的吗啡需求和术后疼痛
DOI：
10.1097/eja.0b013e32832d5426
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发表时间：
2010-01-01
影响因子：
3.6
通讯作者：
Li, Junfa
中科院分区：
文献类型：
--
作者：
Cui, Weihua;Li, Yanping;Li, Junfa
背景与目的瑞芬太尼在快速通道手术中的应用越来越广泛，但有时也会出现严重的术后疼痛。方法40例开胸手术患者随机分为利多卡因(33.0 mg·kg~(-1)·min~(-1))组和生理盐水对照组。靶控输注丙泊酚的血药浓度(C-p)根据脑电双频指数和血压进行调整。用靶控输注泵计算术中异丙酚的C-p和效应点浓度(C-e)。疼痛评分包括四分言语评定量表、Riker镇静-激动量表和视觉模拟评分；术后记录麻醉后护理病房的吗啡用量和通过病房病人自控镇痛器使用的吗啡用量。结果利多卡因组麻醉后护理病房30、30~60、0~120min的吗啡用量显著减少(P
Background and objective Remifentanil is being increasingly used as an analgesic in fast-track surgery, but severe postoperative pain may happen occasionally. In this study, we evaluated the effects of systemic administration of lidocaine on postoperative pain and morphine requirements after propofol-remifentanil-based anaesthesia.Methods Forty patients undergoing thoracic surgery were randomly assigned to lidocaine (33.0 mu g kg(-1) min(-1)) and physiological saline control groups in propofol-remifentanil-based anaesthesia. The setting of the plasma concentration (C-p) of the target-controlled infusion of propofol was adjusted according to the bispectral index of the electroencephalogram and blood pressure. The C-p and effect-site concentration (C-e) of propofol were calculated by target-controlled infusion pump during the intraoperative period. Pain scoring includes a four-point verbal rating scale, Riker's sedation-agitation scale and a visual analogue scale; the morphine requirement in the postanaesthesia care unit and the morphine consumption via a patient-controlled analgesia device on the ward were recorded during the postoperative period.Results Morphine requirements within 30, 30-60 and 0-120 min in the postanaesthesia care unit of the lidocaine group decreased significantly (P