Soda K, Shimanuki K, Yoshida Y, Seo N, Yamanaka T, Sakurabayashi I, Miyata M
Department of Surgery, Jichi Medical School Omiya Medical Center, Saitama, Japan.
Endoscopy. 1994 May;26(4):347-51. doi: 10.1055/s-2007-1008989.
In 20 patients undergoing topical anesthesia for gastroscopic examination, serum concentrations of lidocaine and its metabolite, monomethylglycinexylidide (MEGX), were measured. Patients were divided randomly into two groups: a gel group, in which 5 ml of 2% lidocaine gel was applied to the throat for 20 minutes; and a solution group, in which 40 ml of 2% lidocaine solution was administered by gargling for five minutes. The effect of oropharyngeal anesthesia was comparable in both groups. In the gel group, the serum levels of lidocaine and MEGX were not elevated at 15 minutes after application of the anesthetic. However, in the solution group, a rise in both serum lidocaine and MEGX at 15 minutes after anesthesia was detected in some of the patients (40%). Increased serum MEGX concentrations, which correlated well with serum lidocaine concentrations, were associated with the age of the patient (r = 0.606; p < 0.05), but not with height or weight. As a topical anesthetic for endoscopic examination, we prefer lidocaine gel to lidocaine solution, because the latter might be absorbed more rapidly and unpredictably in some, especially aged patients.
对20例接受胃镜检查局部麻醉的患者，测定了利多卡因及其代谢产物单甲基甘氨酰二甲苯（MEGX）的血清浓度。患者被随机分为两组：凝胶组，将5毫升2%利多卡因凝胶涂于咽喉部20分钟；溶液组，用40毫升2%利多卡因溶液漱口5分钟。两组的口咽麻醉效果相当。在凝胶组，麻醉剂应用后15分钟时利多卡因和MEGX的血清水平未升高。然而，在溶液组，部分患者（40%）在麻醉后15分钟时血清利多卡因和MEGX均升高。血清MEGX浓度升高与血清利多卡因浓度密切相关，与患者年龄有关（r = 0.606；p < 0.05），但与身高或体重无关。作为内镜检查的局部麻醉剂，我们更倾向于利多卡因凝胶而非利多卡因溶液，因为后者在一些患者尤其是老年患者中可能吸收更快且不可预测。
