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[儿童扁桃体切除术后利多卡因气雾剂]

[Lidocaine aerosol following tonsillectomy in children].

作者信息

Bissonnette B

机构信息

Département d'Anesthésie-Réanimation, Hôpital du St-Sacrement, Université Laval, Québec.

出版信息

Can J Anaesth. 1990 Jul;37(5):534-7. doi: 10.1007/BF03006321.

DOI:10.1007/BF03006321
PMID:2197004
Abstract

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.

摘要

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。

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引用本文的文献

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Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial.利多卡因气雾剂术前应用以提高扁桃体切除术和腺样体切除术患儿的舒适度:一项前瞻性随机对照试验。
Health Sci Rep. 2023 Nov 14;6(11):e1688. doi: 10.1002/hsr2.1688. eCollection 2023 Nov.
2
Perioperative local anaesthesia for reducing pain following tonsillectomy.扁桃体切除术后采用围手术期局部麻醉减轻疼痛
Cochrane Database Syst Rev. 2000;1999(2):CD001874. doi: 10.1002/14651858.CD001874.
3
Post-tonsillectomy infiltration with bupivacaine reduces immediate postoperative pain in children.

本文引用的文献

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Fatalities following topical application of local anesthetics to mucous membranes.局部麻醉药局部应用于黏膜后的死亡病例。
J Am Med Assoc. 1956 Dec 22;162(17):1527-30. doi: 10.1001/jama.1956.02970340017006.
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Dangers of injections into the tonsillar fossae after tonsillectomy.扁桃体切除术后向扁桃体窝注射的风险
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The incidence and etiology of postanesthetic excitment. A clinical survey.麻醉后兴奋的发生率及病因。一项临床调查。
扁桃体切除术后用布比卡因浸润可减轻儿童术后即刻疼痛。
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Comparison of paracetamol and pentazocine suppositories for pain relief after tonsillectomy in adults.对乙酰氨基酚与喷他佐辛栓剂用于成人扁桃体切除术后镇痛的比较。
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Plasma lidocaine concentrations following topical aerosol application to the trachea and bronchi.
Can Anaesth Soc J. 1970 May;17(3):250-5. doi: 10.1007/BF03004603.
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An experimental study on the absorption of some local anaesthetics through the lower respiratory tract.关于某些局部麻醉药经下呼吸道吸收的实验研究。
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Post-tonsillectomy morbidity: a clinical trial of a local penicillin-steroid-anesthetic mixture.扁桃体切除术后并发症:局部青霉素 - 类固醇 - 麻醉剂混合物的临床试验
Ann Otol Rhinol Laryngol. 1967 Dec;76(5):1060-6. doi: 10.1177/000348946707600518.
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Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans.利多卡因在人类晚期心力衰竭、肝脏疾病和肾衰竭中的药代动力学。
Ann Intern Med. 1973 Apr;78(4):499-508. doi: 10.7326/0003-4819-78-4-499.