Sztark F, Thicoipé M, Favarel-Garrigues J F, Lassié P, Petitjean M E, Dabadie P
The Emergency Department, Pellegrin University Hospital, Bordeaux, France.
Anesth Analg. 1997 Apr;84(4):777-9. doi: 10.1097/00000539-199704000-00014.
The present study was designed to assess the efficacy of fentanyl and pancuronium combined with dilute lidocaine solution for intravenous regional anesthesia of the arm. Forty adult patients undergoing upper limb surgery were randomly allocated to receive either 0.6 mL/kg of 0.5% lidocaine (3 mg/kg) or 0.6 mL/kg of 0.25% lidocaine (1.5 mg/kg) with 1 microg/kg of fentanyl and 0.5 mg of pancuronium. The onset of sensory and motor blocks was significantly shorter in the 0.5% lidocaine group (P < 0.05). However, no differences in analgesia or motor blockade were found between the two groups at 20 min tourniquet time. Regional anesthesia was considered successful in more than 85% of patients. One patient in the 0.25% lidocaine group experienced a transient diplopia after tourniquet release. Postoperative analgesia time was similar in the two groups. We conclude that the addition of fentanyl plus pancuronium to the lidocaine solution reduces the dose of the local anesthetic and possibly systemic toxicity.
本研究旨在评估芬太尼、潘库溴铵联合稀释利多卡因溶液用于上肢静脉区域麻醉的效果。40例接受上肢手术的成年患者被随机分配，分别接受0.6 mL/kg的0.5%利多卡因（3 mg/kg）或0.6 mL/kg的0.25%利多卡因（1.5 mg/kg），并加用1 μg/kg芬太尼和0.5 mg潘库溴铵。0.5%利多卡因组感觉和运动阻滞的起效时间显著缩短（P < 0.05）。然而，在止血带使用20分钟时，两组之间在镇痛或运动阻滞方面未发现差异。超过85%的患者区域麻醉被认为成功。0.25%利多卡因组有1例患者在止血带松开后出现短暂复视。两组术后镇痛时间相似。我们得出结论，在利多卡因溶液中添加芬太尼和潘库溴铵可降低局部麻醉药的剂量，并可能降低全身毒性。
