本文選題：利多卡因 + 丙泊酚�。� 參考：《臨床麻醉學(xué)雜志》2015年06期

【摘要】：目的探討靜脈輸注利多卡因?qū)Ρ捶影锌剌斪r(shí)不同意識(shí)狀態(tài)的預(yù)測(cè)效應(yīng)部位濃度及熵指數(shù)的影響。方法擇期全麻下骨科下肢手術(shù)患者60例,ASAⅠ或Ⅱ級(jí),年齡18~60歲,隨機(jī)均分為利多卡因1.0mg/kg組(L1組)、利多卡因1.5mg/kg組(L2組)和對(duì)照組(C組)。麻醉開(kāi)始前L1組、L2組分別給予利多卡因1.0mg/kg和1.5mg/kg,C組給予等容量的生理鹽水,1min后采用靶控輸注丙泊酚行全麻誘導(dǎo)。觀察入室安靜后10min(T1)、靶控輸注前(T2)、插管前即刻(T3)、插管后即刻(T4)、插管后3min(T5)、插管后5min(T6)時(shí)熵指數(shù)、MAP、HR、SpO2、OAA/S評(píng)分。記錄靶控輸注期間語(yǔ)言反應(yīng)消失時(shí)(LVC)、意識(shí)消失時(shí)(LOC)即刻的熵指數(shù)和丙泊酚的預(yù)測(cè)效應(yīng)部位濃度。結(jié)果與T1、T2時(shí)比較,C組T3、T5、T6時(shí)和L1、L2組T3~T6時(shí)MAP均明顯降低(P0.01);與T1、T2時(shí)比較,三組T3~T6時(shí)RE和SE均明顯降低(P0.01);與T3時(shí)比較,C組T4時(shí)MAP、HR、RE和SE明顯升高(P0.01或P0.05),而L1、L2組差異無(wú)統(tǒng)計(jì)學(xué)意義。三組患者在LVC、LOC時(shí)的熵指數(shù)和丙泊酚的預(yù)測(cè)效應(yīng)部位濃度差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論靜注利多卡因1.0mg/kg或1.5mg/kg,對(duì)不同意識(shí)狀態(tài)時(shí)丙泊酚靶控輸注的預(yù)測(cè)效應(yīng)部位濃度和熵指數(shù)并無(wú)顯著的影響,但可減輕氣管插管時(shí)的應(yīng)激反應(yīng),并抑制氣管插管刺激時(shí)的熵指數(shù)升高。
[Abstract]:Objective to investigate the effect of intravenous lidocaine on the predictive effect site concentration and entropy index of different conscious states during target controlled infusion of propofol. Methods Sixty patients with lower extremity operation in orthopedic department under general anesthesia were randomly divided into three groups: lidocaine 1.0mg/kg group (L1 group), lidocaine 1.5mg/kg group (L2 group) and control group (C group). The patients with ASA grade 鈪，

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