Brianceau P, Chevalier H, Karas A, Court M H, Bassage L, Kirker-Head C, Provost P, Paradis M R
Schering Plough Animal Health Corporation, Terre Haute, IN, USA.
J Vet Intern Med. 2002 Nov-Dec;16(6):736-41. doi: 10.1892/0891-6640(2002)016<0736:ilassa>2.3.co;2.
Twenty-eight horses with the diagnosis of an intestinal disorder requiring surgical intervention were randomly assigned to lidocaine (n = 13) or saline (control, n = 15) treatment groups. After induction of anesthesia, treated horses received a loading dose of 2% lidocaine (0.65 mg/kg) intravenously, followed by a continuous rate of infusion of 1% lidocaine (0.025 mg/kg/min) until the discontinuation of anesthesia. Upon recovery from anesthesia, a 2nd loading dose of 2% lidocaine (1.3 mg/kg) was administered, followed by an infusion of 1% lidocaine (0.05 mg/kg/min) for 24 hours postoperatively. The control group received equivalent volumes of saline. Lidocaine-treated horses had significantly better minimum jejunal cross-sectional area scores (P = .011), minimum jejunal diameter scores (P = .002), and intestinal ultrasound index (IUI) (P = .007). Peritoneal fluid was detected by percutaneous ultrasound examination in 8 of the 15 control animals but in none of the treated animals (P = .003). Failure to obtain fluid via abdominocentesis was significantly more frequent for lidocaine-treated horses (P = .025). No significant differences between the groups were found in the presence of gastrointestinal sounds, time to passage of 1st feces, number of defecations in the 1st 24 hours, presence of gastric reflux, duodenal or jejunal wall thickness, maximum duodenal or jejunal diameter or cross-sectional area, minimum duodenal diameter or cross-sectional area, duodenal and jejunal intraluminal echogenicity, small-intestinal contractions per minute, rate of complications, or outcome. On the basis of this study, lidocaine infusion may have some desirable effects on jejunal distension and peritoneal fluid accumulation and was well tolerated perioperatively in horses with colic. The low incidence of small-intestinal lesions and gastric reflux in the study makes it difficult to assess the use of lidocaine in the prevention of postoperative ileus (POI).
28匹被诊断患有需要手术干预的肠道疾病的马被随机分为利多卡因治疗组（n = 13）和生理盐水对照组（n = 15）。麻醉诱导后，治疗组马匹静脉注射2%利多卡因负荷剂量（0.65 mg/kg），随后以1%利多卡因持续输注（0.025 mg/kg/min）直至麻醉结束。麻醉苏醒后，给予第二次2%利多卡因负荷剂量（1.3 mg/kg），然后术后24小时输注1%利多卡因（0.05 mg/kg/min）。对照组给予等量生理盐水。利多卡因治疗的马匹空肠最小横截面积评分（P = 0.011）、空肠最小直径评分（P = 0.002）和肠道超声指数（IUI）（P = 0.007）明显更好。15只对照动物中有8只通过经皮超声检查检测到腹腔积液，而治疗组动物均未检测到（P = 0.003）。利多卡因治疗的马匹通过腹腔穿刺未能获得液体的情况明显更频繁（P = 0.025）。两组在肠鸣音、首次排便时间、最初24小时内排便次数、胃反流情况、十二指肠或空肠壁厚度、十二指肠或空肠最大直径或横截面积、十二指肠或空肠最小直径或横截面积、十二指肠和空肠腔内回声、每分钟小肠收缩次数、并发症发生率或结局方面未发现显著差异。基于这项研究，利多卡因输注可能对空肠扩张和腹腔积液有一些有益作用，并且在患有绞痛的马匹围手术期耐受性良好。该研究中小肠病变和胃反流的发生率较低，使得难以评估利多卡因在预防术后肠梗阻（POI）中的应用。
