Stoneham M D, Bree S E, Sneyd J R
Department of Anaesthesia, Royal Naval Hospital, Stonehouse, Plymouth.
Anaesthesia. 1995 May;50(5):464-6. doi: 10.1111/j.1365-2044.1995.tb06007.x.
The effects of pretreatment with lignocaine administered intravenously on the insertion of the laryngeal mask airway were investigated in 80 unpremedicated, ASA 1 or 2, adult day-case patients in a randomised, double-blind, placebo-controlled trial. Patients received either intravenous lignocaine 1.5 mg.kg-1 or an equivalent volume of sodium chloride 0.9%. Induction of anaesthesia was achieved with propofol given via a syringe driver at a fixed rate of 600 ml.h-1 until the patient dropped a weighted syringe. No opioid or sedative drugs were given prior to induction. Pain on injection of propofol was recorded. Jaw opening, ease of insertion of the laryngeal mask, coughing, gagging and airway patency were all scored on three-point scales immediately after mask insertion re-attempted. This cycle was continued until success was achieved and the number of such cycles recorded. There were no differences between the lignocaine and control groups with respect to induction dose of propofol, degree of jaw opening, or amount of gagging. Laryngeal mask insertion was facilitated by pretreatment with lignocaine administered intravenously, without an alteration in induction dose of propofol (p < 0.05). Coughing and airway obstruction were both significantly reduced by pretreatment with lignocaine, as was the incidence of failure of insertion requiring deepening of anaesthesia (p < 0.05).
在一项随机、双盲、安慰剂对照试验中，对80例未使用术前药、ASA 1或2级的成年日间手术患者进行研究，观察静脉注射利多卡因预处理对喉罩置入的影响。患者分别接受静脉注射1.5 mg·kg-1利多卡因或等量的0.9%氯化钠溶液。通过注射器泵以600 ml·h-1的固定速率输注丙泊酚进行麻醉诱导，直至患者掉落一个加重注射器。诱导前未给予阿片类或镇静药物。记录注射丙泊酚时的疼痛情况。在重新尝试置入喉罩后，立即对张口度、喉罩置入的难易程度、咳嗽、 gag反射和气道通畅情况进行三分制评分。持续此循环直至成功，并记录循环次数。利多卡因组和对照组在丙泊酚诱导剂量、张口度或 gag反射程度方面无差异。静脉注射利多卡因预处理有助于喉罩置入，且丙泊酚诱导剂量无变化（p<0.05）。利多卡因预处理显著减少了咳嗽和气道梗阻，以及需要加深麻醉才能成功置入喉罩的发生率（p<0.05）。
