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静脉注射利多卡因对舒芬太尼诱导麻醉期间气管插管时血液动力学反应的影响。

The effect of intravenous lidocaine on hemodynamic response to endotracheal intubation during sufentanil-based induction of anaesthesia.

机构信息

Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, PR China.

出版信息

Anaesthesiol Intensive Ther. 2020;52(4):287-291. doi: 10.5114/ait.2020.99918.

Abstract

INTRODUCTION

Endotracheal intubation (ETI) can cause a cardiovascular response. The aim of the present study was to investigate the effect of intravenous lidocaine on the hemodynamic response to ETI during sufentanil-based induction of anaesthesia.

MATERIAL AND METHODS

Ninety patients aged 18-65 years were recruited, induction of anaesthesia was initiated by sufentanil, midazolam, cisatracurium, and propofol, the patients were randomized to three groups: Group L1 received 1 mg/kg-1 of lidocaine, Group L1.5 received 1.5 mg kg-1 of lidocaine, Group S received an equal volume of normal saline (NS). Lidocaine or NS was administered in a bolus 2 min before ETI. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), and heart rate (HR) were recorded at four time points: before anaesthetic induction, 1 min after lidocaine administration, immediately after ETI, 5 min after ETI. The incidences of hypotension, hypertension, bradycardia, and tachycardia were also recorded.

RESULTS

The SAP, DAP, MAP, and HR at baseline were not significantly different among the three groups (P = 0.620, P = 0.575, P = 0.433, P = 0.537, respectively). Immediately after ETI, the SAP in Group L1 was significantly lower than Group S (P = 0.024), while the DAP, MAP, and HR were comparable among the three groups at the same time points (P > 0.05). There were no significant differences in the incidences of hypotension, hypertension, bradycardia and tachycardia among the three groups (P > 0.200).

CONCLUSIONS

Intravenous lidocaine could attenuate the increase of blood pressure but not HR after ETI during sufentanil-based induction of anaesthesia without increased incidence of side-effects.

摘要

简介

气管插管(ETI)可引起心血管反应。本研究旨在探讨舒芬太尼诱导麻醉时静脉利多卡因对 ETI 引起的血流动力学反应的影响。

材料和方法

招募了 90 名年龄在 18-65 岁的患者,麻醉诱导采用舒芬太尼、咪达唑仑、顺式阿曲库铵和丙泊酚,患者随机分为三组:L1 组给予 1mg/kg-1 的利多卡因,L1.5 组给予 1.5mg/kg-1 的利多卡因,S 组给予等量的生理盐水(NS)。在 ETI 前 2 分钟,给予利多卡因或 NS 推注。在四个时间点记录收缩压(SAP)、舒张压(DAP)、平均动脉压(MAP)和心率(HR):麻醉诱导前、利多卡因给药后 1 分钟、ETI 后即刻、ETI 后 5 分钟。还记录了低血压、高血压、心动过缓和心动过速的发生率。

结果

三组患者的 SAP、DAP、MAP 和 HR 在基线时无显著差异(P = 0.620,P = 0.575,P = 0.433,P = 0.537,分别)。ETI 后即刻,L1 组的 SAP 明显低于 S 组(P = 0.024),而在同一时间点,三组的 DAP、MAP 和 HR 无显著差异(P > 0.05)。三组患者低血压、高血压、心动过缓和心动过速的发生率无显著差异(P > 0.200)。

结论

舒芬太尼诱导麻醉时,静脉注射利多卡因可减轻 ETI 后血压升高,但对心率无影响,且不良反应发生率无增加。

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