Bissonnette B
Département d'Anesthésie-Réanimation, Hôpital du St-Sacrement, Université Laval, Québec.
Can J Anaesth. 1990 Jul;37(5):534-7. doi: 10.1007/BF03006321.
Post-tonsillectomy analgesia was compared using ten per cent aerosol lidocaine or 1.5 mg.kg-1 intramuscular codeine. Thirty ASA physical status I or II children between two and ten years of age were assigned, in a random fashion, to one of two groups: Group A received codeine 1.5 mg.kg-1 intramuscularly, Group B received a total dose of 4 mg.kg-1 of ten per cent aerosol lidocaine on the tonsillar beds. For both groups, the treatment was administered at the end of the surgical procedure. The postoperative comfort state was assessed on a global scale using the following statement: (1) comfortable = 1, (2) agitation = 2, (3) uncontrollable = 3. Assessment of postoperative comfort was recorded after 20 min in the post-anaesthetic recovery room. Blood samples for lidocaine concentration estimation were obtained at 5, 7.5, 10, and 15 min after administration. Finally, the time of recovery was recorded. The immediate post-anaesthetic comfort observed with ten per cent aerosol lidocaine was statistically superior to that obtained with 1.5 mg.kg-1 intramuscular codeine. The maximal systemic lidocaine concentration which was 2.1 +/- 0.2 micrograms.ml-1 was well below the accepted toxic level of 5.3 micrograms.ml-1. The recovery room times were not statistically different between the two groups. In conclusion, 4 mg.kg-1 of ten per cent aerosol lidocaine applied directly on the tonsillar beds was shown a superior immediate post-tonsillectomy analgesic technique.
采用10%利多卡因气雾剂或1.5mg.kg-1的肌内注射可待因对扁桃体切除术后镇痛进行比较。将30名年龄在2至10岁之间、美国麻醉医师协会(ASA)身体状况为I或II级的儿童随机分为两组:A组肌内注射1.5mg.kg-1的可待因,B组在扁桃体床给予总量为4mg.kg-1的10%利多卡因气雾剂。两组均在手术结束时进行治疗。术后舒适度采用以下表述进行整体评估:(1)舒适=1,(2)烦躁=2,(3)无法控制=3。在麻醉后恢复室20分钟后记录术后舒适度评估结果。给药后5、7.5、10和15分钟采集血样以测定利多卡因浓度。最后,记录恢复时间。观察到10%利多卡因气雾剂麻醉后即刻的舒适度在统计学上优于1.5mg.kg-1肌内注射可待因所获得的舒适度。最大全身利多卡因浓度为2.1±0.2微克/毫升,远低于公认的5.3微克/毫升的中毒水平。两组在恢复室的停留时间在统计学上无差异。总之,直接应用于扁桃体床的4mg.kg-1的10%利多卡因气雾剂显示为一种更优的扁桃体切除术后即刻镇痛技术。