Pucino F, Danielson B D, Carlson J D, Strommen G L, Walker P R, Beck C L, Thiege D J, Gill D S
Department of Pharmacy Practice, College of Pharmacy, North Dakota State University, Fargo.
Drug Intell Clin Pharm. 1988 Sep;22(9):676-9. doi: 10.1177/106002808802200904.
Hypokalemia is a common electrolyte abnormality. Intravenous repletion therapy with potassium chloride (KCl) in concentrations greater than 80-100 mEq/L is not recommended due to patient intolerance. Since this guideline at times may be clinically impractical, this study was designed to examine use of peripheral vein infusions of high concentration KCl therapy. Tolerance to KCl 20 mEq/65 ml iv with and without lidocaine 50 mg was evaluated in 18 hypokalemic subjects in a randomized, placebo-controlled, double-blind study. Subjective and objective assessments of adverse effects were determined throughout the infusion period. Pain was assessed by both verbal descriptor and visual analog scales and correlated significantly following infusion of KCl with or without lidocaine. Multivariant analysis demonstrated differences in pain perception between solutions, with significantly less pain following KCl with lidocaine versus KCl infusions. Transient adverse effects occurred in both groups, but the incidence was not statistically different. Use of concentrated iv KCl infusions may benefit hypokalemic patients with hypervolemia and/or severe potassium deficits. Addition of lidocaine clearly improves patient tolerance to intravenous KCl replacement.
低钾血症是一种常见的电解质异常。由于患者耐受性问题，不建议使用浓度大于80 - 100 mEq/L的氯化钾（KCl）进行静脉补充治疗。鉴于该指南有时在临床实践中可能不切实际，本研究旨在探讨外周静脉输注高浓度KCl治疗的应用情况。在一项随机、安慰剂对照、双盲研究中，对18名低钾血症患者评估了含50 mg利多卡因和不含利多卡因的20 mEq/65 ml静脉注射KCl的耐受性。在整个输注期间确定了对不良反应的主观和客观评估。通过语言描述和视觉模拟量表评估疼痛，在输注含或不含利多卡因的KCl后疼痛有显著相关性。多变量分析显示不同溶液之间在疼痛感知上存在差异，与单独输注KCl相比，输注含利多卡因的KCl时疼痛明显减轻。两组均出现短暂不良反应，但发生率无统计学差异。使用浓缩静脉注射KCl可能使伴有血容量过多和/或严重钾缺乏的低钾血症患者受益。添加利多卡因明显提高了患者对静脉注射KCl补充治疗的耐受性。
