Lev R, Rosen P
Department of Emergency Medicine, University of California, San Diego 92103-8676.
J Emerg Med. 1994 Jul-Aug;12(4):499-506. doi: 10.1016/0736-4679(94)90347-6.
This article is a review of the use of prophylactic lidocaine as a preintubation medication. Intubation is associated with a cardiovascular response of elevated blood pressure and pulse, cough reflexes, occasional dysrhythmias, increased intracranial pressure, and increased intraocular pressure. In patients with atherosclerotic heart disease, potential intracranial lesions, and potential penetrating eye injuries, these responses to intubation are of greater risk. Various studies have reviewed the effect of lidocaine to blunt these responses. It is agreed that lidocaine blunts cough reflexes and dysrhythmias. Some studies note a response of lidocaine in blunting rises in pulse, blood pressure, intracranial and intraocular pressure. No studies document any harmful effects of prophylactic lidocaine given preintubation. A dose of prophylactic lidocaine of 1.5 mg/kg given intravenously 3 minutes before intubation is optimal. For suctioning of intubated patients, lidocaine can be given endotracheally in a 5-6 mg/kg dose diluted in 6 cc via simple administration at the entrance to the endotracheal tube.
本文是一篇关于预防性使用利多卡因作为插管前用药的综述。插管会引发一系列心血管反应，包括血压升高、脉搏加快、咳嗽反射、偶尔出现的心律失常、颅内压升高和眼压升高。对于患有动脉粥样硬化性心脏病、潜在颅内病变以及潜在穿透性眼外伤的患者，这些插管反应的风险更大。多项研究探讨了利多卡因减轻这些反应的效果。人们一致认为，利多卡因可减轻咳嗽反射和心律失常。一些研究指出，利多卡因对减轻脉搏、血压、颅内压和眼压升高有作用。没有研究记录插管前预防性使用利多卡因有任何有害影响。插管前3分钟静脉注射1.5mg/kg的预防性利多卡因剂量最为合适。对于已插管患者的吸痰，利多卡因可经气管内给药，剂量为5 - 6mg/kg，用6cc稀释后通过气管导管入口处简单给药。
