Yukioka H, Hayashi M, Terai T, Fujimori M
Department of Anesthesiology and Intensive Care Medicine, Osaka City University Medical School, Japan.
Anesth Analg. 1993 Aug;77(2):309-12. doi: 10.1213/00000539-199308000-00016.
The effects of intravenously administered lidocaine on cough suppression in elderly patients over the age of 60 yr during tracheal intubation under general anesthesia were evaluated in two studies. In the first study, 100 patients received a placebo of either 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. The incidence of coughing decreased as the dose of lidocaine increased. A dose of 1.5 mg/kg or more of intravenous lidocaine suppressed the cough reflex significantly (P < 0.01). In the second study, 108 patients received 2 mg/kg lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation. The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in Study 1. The incidence of coughing decreased significantly (P < 0.01) when 2 mg/kg lidocaine was injected intravenously between 1 min and 3 min before attempting intubation. The cough reflex was almost entirely suppressed by plasma concentrations of lidocaine in excess of 4 micrograms/mL. The results suggest that intravenous administration of lidocaine is effective in suppressing the cough reflex during tracheal intubation in elderly patients under general anesthesia, but that relatively high plasma concentrations of lidocaine may be required for suppression of coughing.
两项研究评估了静脉注射利多卡因对60岁以上老年患者在全身麻醉下气管插管期间咳嗽抑制的效果。在第一项研究中，100例患者在气管插管前1分钟静脉注射0.5、1.0、1.5或2.0mg/kg利多卡因的安慰剂。所有可见的咳嗽均归类为咳嗽。咳嗽发生率随着利多卡因剂量的增加而降低。静脉注射1.5mg/kg或更高剂量的利多卡因可显著抑制咳嗽反射（P<0.01）。在第二项研究中，108例患者在插管前1、3、5、7、10或15分钟静脉注射2mg/kg利多卡因或安慰剂。确定患者在气管插管期间是否咳嗽的标准与研究1相同。在尝试插管前1至3分钟静脉注射2mg/kg利多卡因时，咳嗽发生率显著降低（P<0.01）。当利多卡因血浆浓度超过4μg/mL时，咳嗽反射几乎完全被抑制。结果表明，静脉注射利多卡因可有效抑制老年患者在全身麻醉下气管插管期间的咳嗽反射，但可能需要相对较高的利多卡因血浆浓度来抑制咳嗽。
