Department of Anesthesiology, Brain Hospital Affiliated to Nanjing Medical University, NanjingChina.
Department of Neurosurgery, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Medicine (Baltimore). 2022 Aug 12;101(32):e29965. doi: 10.1097/MD.0000000000029965.
To investigate the effect of low-dose lidocaine on motor evoked potentials (MEPs) in patients undergoing intracranial tumor resection with propofol anesthesia.
Forty patients who underwent intracranial tumor resection and required MEP monitoring were selected. They were randomly divided into the lidocaine group (group L, n = 20) and the control group (group C, n = 20) by computer-generated randomization. All patients were given propofol anesthesia under the guidance of the bispectral index. In group L, 1 mg/kg of lidocaine was injected intravenously during anesthesia induction. Then, lidocaine was continuously pumped at a speed of 1 mg/kg/h until the operation started. Group C was given an equal volume of normal saline. Heart rate (HR), mean artery pressure (MAP), and bispectral index were recorded before anesthesia induction (T0), 2 minutes after tracheal intubation (T1), and 35 minutes (T2), and 50 minutes (T3) after anesthesia induction. The amplitude and latency of MEP at T2 and T3, the total dosage of propofol after anesthesia induction, and adverse events before T3 were recorded.
Compared with those in group C, HR and MAP were significantly decreased at T1 in group L. No significant differences were observed in HR and MAP at T0, T2, and T3 between group L and group C. The total dosage of propofol and the incidence of adverse events were significantly lower in group L than in group C before T3. There were no significant differences in the amplitude and latency of MEP between the 2 groups at each time point.
Low-dose lidocaine has no obvious effect on MEP in patients undergoing intracranial tumor resection. However, it increased hemodynamic stability, reduced propofol use, and decreased the incidence of adverse events.
探讨低剂量利多卡因对异丙酚麻醉下颅内肿瘤切除术患者运动诱发电位（MEPs）的影响。
选择 40 例行颅内肿瘤切除术且需要 MEPs 监测的患者，采用计算机产生的随机数将其分为利多卡因组（L 组，n=20）和对照组（C 组，n=20）。所有患者均在脑电双频指数指导下接受异丙酚麻醉。L 组在麻醉诱导时静脉注射 1mg/kg 利多卡因，然后以 1mg/kg/h 的速度持续泵注至手术开始。C 组给予等容量生理盐水。记录麻醉诱导前（T0）、气管插管后 2 分钟（T1）、麻醉诱导后 35 分钟（T2）和 50 分钟（T3）的心率（HR）、平均动脉压（MAP）和脑电双频指数。记录 T2 和 T3 时 MEP 的振幅和潜伏期、麻醉诱导后丙泊酚的总用量以及 T3 前的不良反应。
与 C 组相比，L 组 T1 时 HR 和 MAP 明显降低。L 组和 C 组在 T0、T2 和 T3 时 HR 和 MAP 无显著差异。与 C 组相比，L 组在 T3 前丙泊酚总用量和不良反应发生率显著降低。两组在各时间点的 MEP 振幅和潜伏期均无显著差异。
低剂量利多卡因对颅内肿瘤切除术患者的 MEP 无明显影响，但可增加血流动力学稳定性，减少丙泊酚用量，降低不良反应发生率。
