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术中静脉注射利多卡因可减少男性开腹胃癌手术后的住院时间。

Intraoperative intravenous lidocaine reduces hospital length of stay following open gastrectomy for stomach cancer in men.

机构信息

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea.

出版信息

J Clin Anesth. 2012 Sep;24(6):465-70. doi: 10.1016/j.jclinane.2012.02.006.

Abstract

STUDY OBJECTIVE

To evaluate whether intraoperative low-dose lidocaine infusion decreases postoperative analgesic consumption, ileus, and duration of hospital stay.

DESIGN

Prospective, randomized, double-blinded trial.

SETTING

Operating room in a university hospital.

PATIENTS

48 ASA physical status 1 and 2 men scheduled for subtotal gastrectomy.

INTERVENTIONS

Patients were randomly allocated to two groups to receive either intravenous (IV) lidocaine 1.5 mg/kg 20 minutes before incision followed by a continuous lidocaine infusion of 1.5 mg/kg/hr until the end of surgery (lidocaine group) or saline in a similar manner (control group).

MEASUREMENTS

Outcomes such as pain intensity, postoperative analgesic consumption, duration of ileus, and hospital length of stay (LOS) were recorded.

MAIN RESULTS

There were no differences in total consumption of IV patient-controlled analgesia (IVPCA) or pain scores at 24, 48, or 72 hours postoperatively. However, lidocaine group patients had significantly decreased average supplemental pethidine requirement per patient for pain control until 72 hours postoperatively [150 (75-200) mg vs 50 (50-150) mg, P = 0.039] and hospital LOS (9.5 ± 3 d vs 8.7 ± 1 d, P = 0.006, 95% CI: - 0.3 - 1.9 d) than control group patients. However, no differences were noted between the groups in pain intensity or duration of ileus.

CONCLUSIONS

Intraoperative IV low-dose lidocaine infusion decreased opioid consumption and hospital LOS after gastrectomy.

摘要

研究目的

评估术中低剂量利多卡因输注是否可减少术后阿片类药物的消耗、肠麻痹及住院时间。

设计

前瞻性、随机、双盲试验。

地点

大学医院手术室。

患者

48 名 ASA 身体状况 1 级和 2 级男性,计划行胃大部切除术。

干预

患者随机分为两组,分别接受静脉(IV)利多卡因 1.5mg/kg 于切开前 20 分钟,然后以 1.5mg/kg/hr 的速度持续输注利多卡因直至手术结束(利多卡因组)或以类似方式输注生理盐水(对照组)。

测量

记录疼痛强度、术后阿片类药物消耗、肠麻痹持续时间和住院时间(LOS)等结果。

主要结果

两组患者在术后 24、48 或 72 小时的总 IV 患者自控镇痛(IVPCA)消耗或疼痛评分方面均无差异。然而,利多卡因组患者在术后 72 小时内用于疼痛控制的平均额外哌替啶需求显著减少[150(75-200)mg 比 50(50-150)mg,P=0.039],住院 LOS 也显著减少[9.5±3d 比 8.7±1d,P=0.006,95%CI:-0.3-1.9d]。然而,两组在疼痛强度或肠麻痹持续时间方面无差异。

结论

胃切除术后,术中 IV 给予低剂量利多卡因可减少阿片类药物的消耗和住院时间。

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