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利多卡因对行胃镜镇静患者丙泊酚剂量和疗效的影响。

Effect of Lidocaine on Ciprofol Dosage and Efficacy in Patients Who Underwent Gastroscopy Sedation.

机构信息

Department of Anesthesiology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.

Department of Anesthesiology, General Hospital of Southern Theatre Command, Guangzhou, Guangdong, China.

出版信息

Med Sci Monit Basic Res. 2024 Nov 7;30:e945751. doi: 10.12659/MSMBR.945751.

DOI:10.12659/MSMBR.945751
PMID:39506303
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11555886/
Abstract

BACKGROUND Intravenous ciprofol is a short-acting sedative with minimal respiratory and circulatory suppression and limited analgesia. Intravenous lidocaine provides analgesia during surgical procedures. This study included 70 patients who underwent gastroscopy with analgesia and aimed to evaluate the effects of intravenous lidocaine on the dose of ciprofol required to produce 50% of the maximal effect (ED50). MATERIAL AND METHODS Seventy patients scheduled for elective painless gastroscopy were randomly assigned into 2 groups: group L (n=35, received ciprofol and 1.5 mg/kg lidocaine) and group S (n=35, received ciprofol and normal saline). The primary outcomes measured were the ED50 and the 95% effective dose (ED95) of ciprofol, determined using the modified up-down sequential method and Probit analysis. Secondary outcomes included induction, operation, and recovery times; monitoring of vital signs such as mean arterial pressure, heart rate, and oxygen saturation; and evaluation of postoperative adverse reactions, including sore throat, nausea, vomiting, abdominal pain, and satisfaction scores from endoscopists and anesthesiologists. RESULTS The ED50 of ciprofol in group L was 0.315 mg/kg (95% CI, 0.291-0.342 mg/kg), which was significantly lower than that in group S, 0.42 mg/kg (95% CI, 0.371-0.491 mg/kg). Additionally, group L exhibited shorter induction and recovery times, a lower incidence of postoperative sore throat, and a temporary drop in blood pressure following induction. CONCLUSIONS Intravenous lidocaine during painless gastroscopy reduces the required ciprofol dose, shortens induction and recovery times, and lowers the incidence of postoperative complications, such as sore throat. These findings support its effective role in improving sedation quality and patient outcomes during gastroscopy.

摘要

背景

静脉注射西普罗酚是一种短效镇静剂,对呼吸和循环抑制作用最小,镇痛作用有限。静脉注射利多卡因可在手术过程中提供镇痛。本研究纳入了 70 例行镇痛胃镜检查的患者,旨在评估静脉注射利多卡因对产生西普罗酚 50%最大效应所需剂量(ED50)的影响。

材料和方法

70 例行择期无痛胃镜检查的患者随机分为 2 组:L 组(n=35,给予西普罗酚和 1.5mg/kg 利多卡因)和 S 组(n=35,给予西普罗酚和生理盐水)。主要结局测量指标为西普罗酚的 ED50 和 95%有效剂量(ED95),采用改良上下序贯法和概率分析进行测定。次要结局包括诱导、操作和恢复时间;监测平均动脉压、心率和血氧饱和度等生命体征;以及评估术后不良反应,包括咽痛、恶心、呕吐、腹痛和内镜医生和麻醉医生的满意度评分。

结果

L 组西普罗酚的 ED50 为 0.315mg/kg(95%可信区间,0.291-0.342mg/kg),明显低于 S 组的 0.42mg/kg(95%可信区间,0.371-0.491mg/kg)。此外,L 组诱导和恢复时间更短,术后咽痛发生率更低,诱导后血压暂时下降。

结论

无痛胃镜检查时静脉注射利多卡因可减少所需西普罗酚剂量,缩短诱导和恢复时间,并降低术后咽痛等并发症的发生率。这些发现支持其在改善胃镜检查镇静质量和患者结局方面的有效作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a4/11555886/eb7cec85e68c/medscimonitbasicres-30-945751-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a4/11555886/41837945c1d2/medscimonitbasicres-30-945751-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a4/11555886/eb7cec85e68c/medscimonitbasicres-30-945751-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a4/11555886/41837945c1d2/medscimonitbasicres-30-945751-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97a4/11555886/eb7cec85e68c/medscimonitbasicres-30-945751-g002.jpg

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BMC Anesthesiol. 2024 Jan 2;24(1):2. doi: 10.1186/s12871-023-02387-4.
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