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鞘内注射利多卡因和舒芬太尼可缩短门诊直肠手术后的恢复时间。

Intrathecal lidocaine and sufentanil shorten postoperative recovery after outpatient rectal surgery.

作者信息

Waxler Beverly, Mondragon Shirley A, Patel Sonal N, Nedumgottil Kochuthresia

机构信息

Division of Postanesthesia Care, Department of Anesthesiology and Pain Management, John H. Stroger Jr. Hospital of Cook County, 1901 West Harrison Street, Chicago, IL 60612, USA.

出版信息

Can J Anaesth. 2004 Aug-Sep;51(7):680-4. doi: 10.1007/BF03018425.

Abstract

PURPOSE

A short recovery time for same day surgery is important to the patient and the hospital. A prospective, randomized, double-blinded study in the postanesthetic care unit was designed to compare the recovery time from spinal anesthesia with low-dose intrathecal (IT) lidocaine and sufentanil to that with IT lidocaine alone. The incidence of adverse effects was also assessed.

METHODS

Forty-nine patients (ASA I-III, age 20-69 yr) underwent spinal anesthesia for rectal surgery. The patients were randomized into two groups. One group (n = 28) received low-dose IT lidocaine (15 mg) and sufentanil (10 microg) and the other group (n = 21) received IT lidocaine (50 mg). The time to ambulation, the incidence of pruritus, and other variables were recorded. Statistical difference was assumed if P < 0.05.

RESULTS

Our results show a significantly shorter ambulation time (120 +/- 26 min) after IT low-dose lidocaine (15 mg) and 10 microg sufentanil vs 50 mg IT lidocaine (162 +/- 32 min, P < 0.0001). Patients who received IT lidocaine and sufentanil recovered faster. Fifty percent of the patients who received IT sufentanil suffered from pruritus.

CONCLUSION

IT lidocaine (15 mg) and sufentanil resulted in a shorter time to ambulation compared to IT lidocaine (50 mg) alone and provided excellent anesthesia despite its disadvantage of pruritus.

摘要

目的

同日手术的短恢复时间对患者和医院都很重要。在麻醉后护理单元进行了一项前瞻性、随机、双盲研究,旨在比较低剂量鞘内注射(IT)利多卡因和舒芬太尼与单纯IT利多卡因的脊髓麻醉恢复时间。还评估了不良反应的发生率。

方法

49例患者(ASA I-III级,年龄20-69岁)接受直肠手术的脊髓麻醉。患者被随机分为两组。一组(n = 28)接受低剂量IT利多卡因(15 mg)和舒芬太尼(10 μg),另一组(n = 21)接受IT利多卡因(50 mg)。记录下床活动时间、瘙痒发生率和其他变量。如果P < 0.05,则认为存在统计学差异。

结果

我们的结果显示,与50 mg IT利多卡因(162 +/- 32分钟,P < 0.0001)相比,低剂量IT利多卡因(15 mg)和10 μg舒芬太尼后的下床活动时间显著缩短(120 +/- 26分钟)。接受IT利多卡因和舒芬太尼的患者恢复更快。接受IT舒芬太尼的患者中有50%出现瘙痒。

结论

与单独使用IT利多卡因(50 mg)相比,IT利多卡因(15 mg)和舒芬太尼可缩短下床活动时间,尽管存在瘙痒这一缺点,但仍提供了良好的麻醉效果。

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