Totonchi Ziya, Salajegheh Shirin, Mohaghegh Mahmoud Reza, Kiaei Mehrdad Mesbah, Shirvani Mohammad, Ghorbanlo Masoud
Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran.
Shafa Hospital, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Interv Med Appl Sci. 2017 Jun;9(2):56-60. doi: 10.1556/1646.9.2017.2.06.
Dissection of aorta is a rare, but fatal complication of aortic cannulation in cardiac surgery can be caused by the sudden rise in blood pressure and hemodynamic variations.
In this study, 90 patients aged 18 years or older undergoing cardiac surgery were divided into two equal groups. Under similar conditions, trial group received 1.5 mg/kg of lidocaine for 90 s before cannulation and control group received normal saline. Hemodynamic parameters of patients including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and central venous pressure before cannulation and 1, 3, and 5 min after cannulation were recorded in a form. Consumed nitroglycerin (TNG) rate was also measured and recorded.
In the lidocaine group, compared with the placebo group, mean SBP, DBP, and MAP significantly reduced after cannulation ( < 0.05). During the follow-up period, mean HR ( = 0.649) and TNG usage ( = 0.527) were similar in two groups.
Intravenous lidocaine, 1.5 mg/kg, 90 s before cannulation leads to a reduction in SBP, DBP, and MAP, up to 5 min after cannulation, so it can decrease risk of aortic dissection.
主动脉夹层是心脏手术中主动脉插管罕见但致命的并发症，可由血压突然升高和血流动力学变化引起。
本研究将90例18岁及以上接受心脏手术的患者分为两组，每组人数相等。在相似条件下，试验组在插管前90秒给予1.5mg/kg利多卡因，对照组给予生理盐水。以表格形式记录患者插管前及插管后1、3和5分钟的血流动力学参数，包括收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）和中心静脉压。还测量并记录硝酸甘油（TNG）的使用量。
利多卡因组与安慰剂组相比，插管后平均SBP、DBP和MAP显著降低（<0.05）。随访期间，两组的平均HR（=0.649）和TNG使用量（=0.527）相似。
插管前90秒静脉注射1.5mg/kg利多卡因可使插管后5分钟内SBP、DBP和MAP降低，因此可降低主动脉夹层的风险。
