Ameer B, Burlingame M B, Harman E M
Department of Pharmacy Practice, University of Florida, Gainesville.
Pharmacotherapy. 1989;9(2):74-81. doi: 10.1002/j.1875-9114.1989.tb04106.x.
This study compared the systemic absorption of topically administered lidocaine in elderly and young adult patients who were undergoing fiberoptic bronchoscopy. Fourteen elderly subjects aged 60-72 years (mean 67 years) and five young subjects age 31-48 years (mean 42 years) were compared with respect to dosage requirements to achieve satisfactory local anesthesia, rate and extent of lidocaine systemic absorption, plasma drug levels, elimination half-life, and drug side effects. Blood samples were drawn prior to, during, and for an average of 3 hours after the completion of bronchoscopy. Lidocaine plasma concentrations averaged in the range of 3.04-0.88 micrograms/ml from the beginning of the procedure to the end of blood sampling. Despite high cumulative amounts of 19 mg/kg (1200 mg) of lidocaine administered topically, the regimen proved relatively safe and achieved satisfactory anesthesia. In patients without known risk factors either for delayed hepatic lidocaine clearance or for enhanced mucosal absorption, the regimen is suitable for both young and old individuals.
本研究比较了接受纤维支气管镜检查的老年和青年成年患者局部应用利多卡因后的全身吸收情况。将14名年龄在60 - 72岁（平均67岁）的老年受试者和5名年龄在31 - 48岁（平均42岁）的青年受试者在实现满意局部麻醉所需剂量、利多卡因全身吸收的速率和程度、血浆药物水平、消除半衰期以及药物副作用方面进行了比较。在支气管镜检查前、检查期间以及检查完成后平均3小时采集血样。从操作开始到血样采集结束，利多卡因血浆浓度平均在3.04 - 0.88微克/毫升范围内。尽管局部应用了高达19毫克/千克（1200毫克）的利多卡因累积量，但该方案证明相对安全且实现了满意的麻醉效果。对于没有已知肝利多卡因清除延迟或黏膜吸收增强风险因素的患者，该方案适用于年轻人和老年人。
