纤维支气管镜检查前、检查期间及检查后的利多卡因血清浓度。

Serum concentrations of lignocaine before, during and after fiberoptic bronchoscopy.

作者信息

Loukides S, Katsoulis K, Tsarpalis K, Panagou P, Kalogeropoulos N

机构信息

Department of Thoracic Medicine, Athens Army General Hospital, Athens, Greece.

出版信息

Respiration. 2000;67(1):13-7. doi: 10.1159/000029456.

DOI:10.1159/000029456

PMID:10705256

Abstract

BACKGROUND

Lignocaine is commonly used for local anesthesia during fiberoptic bronchoscopy (FOB). Several studies have reported the peak serum concentration of lignocaine in relation to time, but most of them did not specify the administered dose of lignocaine gel and its possible correlation with peak serum concentration.

OBJECTIVE

The aim of our study was to record the plasma concentrations of lignocaine before, during and after FOB and to evaluate whether the doses for nasal and tracheobronchial anesthesia have any correlation with the peak serum concentrations of the drug.

METHODS

Twelve patients with no comorbid conditions undergoing FOB were studied. Lignocaine was administered as a 2% solution using a larynx syringe, 2% gel (mean dose 182.5 +/- 15 mg) and finally 2% solution through the bronchoscope (mean dose 339 +/- 12 mg). Total dose was 622 +/- 20 mg. Venous blood samples were taken before the beginning of local anesthesia and then at 5, 10, 20, 60, 90 and 120 min thereafter.

RESULTS

Our results showed that peak plasma concentrations of lignocaine were observed in 8 patients 20 min after the beginning of local anesthesia, in 3 patients 30 min afterwards and in 1 patient 60 min afterwards (2.15 +/- 0.4 microg/ml, 1.9 +/- 0.3 microg/ml, 1. 81 microg/ml, respectively). None of our patients exceeded the critical level of toxicity (5 microg/ml). Both the total and tracheobronchial doses of lignocaine were significantly correlated with peak serum concentration (r = 0.63, p = 0.05 and r = 0.64, p = 0.02, respectively). No correlation was found between the dose for nasal anesthesia and peak serum concentration. No adverse reactions were observed.

CONCLUSIONS

In conclusion our data show that although the amount of lignocaine used in this study exceeded the recommended highest dose (400 mg) in all patients, no toxic levels were observed. Peak plasma concentrations were found within 20-30 min from the beginning of local anesthesia. The dose for the anesthesia of nasal mucosa represented a significant percentage of the total dose, but did not correlate with the peak serum concentration of the drug.

摘要

背景

利多卡因常用于纤维支气管镜检查（FOB）期间的局部麻醉。多项研究报告了利多卡因血清峰值浓度与时间的关系，但其中大多数未明确利多卡因凝胶的给药剂量及其与血清峰值浓度的可能相关性。

目的

我们研究的目的是记录FOB术前、术中和术后利多卡因的血浆浓度，并评估鼻和气管支气管麻醉剂量与该药物血清峰值浓度之间是否存在任何相关性。

方法

对12例无合并症且接受FOB的患者进行研究。利多卡因以2%溶液通过喉注射器给药，然后给予2%凝胶（平均剂量182.5±15mg），最后通过支气管镜给予2%溶液（平均剂量339±12mg）。总剂量为622±20mg。在局部麻醉开始前以及此后的5、10、20、60、90和120分钟采集静脉血样。

结果

我们的结果显示，8例患者在局部麻醉开始后20分钟出现利多卡因血浆峰值浓度，3例患者在30分钟后出现，1例患者在60分钟后出现（分别为2.15±0.4μg/ml、1.9±0.3μg/ml、1.81μg/ml）。我们的患者均未超过毒性临界水平（5μg/ml）。利多卡因的总剂量和气管支气管剂量均与血清峰值浓度显著相关（分别为r = 0.63，p = 0.05和r = 0.64，p = 0.02）。未发现鼻麻醉剂量与血清峰值浓度之间存在相关性。未观察到不良反应。