Narcotrend监测下静注利多卡因在宫腔镜手术麻醉中的应用

发布时间：2018-04-16 21:39

本文选题：Narcotrend监测 + 利多卡因　；参考：《实用医学杂志》2017年18期

【摘要】：目的观察Narcotrend麻醉深度指数(NT)监测下静注利多卡因在宫腔镜手术中的应用效果。方法 80例择期宫腔镜手术患者,随机分为生理盐水组(S组)和利多卡因组(L组)。L组于麻醉诱导前静脉注射利多卡因1.5 mg/kg作为负荷量,随后以2 mg/(kg·h)持续输注至术毕;S组给予等容量的生理盐水。两组患者均采用NT监测麻醉镇静深度,麻醉方式为丙泊酚、瑞芬太尼全凭静脉麻醉。记录两组患者手术时间(T_1),丙泊酚和瑞芬太尼总量,苏醒时间(T_2),术后0.5 h(T_3),4 h(T_4),24 h(T_5)静息时的术后视觉模拟评分(VAS),咽喉疼痛发生率,利多卡因不良反应。结果两组患者的年龄、体质量、T_1、T_2和丙泊酚总量差异均无统计学意义(P0.05)。L组瑞芬太尼用量明显少于S组(P0.05)。静息时VAS评分T_3,T_4时L组低于S组(P0.05),而T_5无明显差异。咽喉疼痛发生率L组明显低于S组(P0.05)。L组未见利多卡因不良反应。结论 Narcotrend监测下静脉输注利多卡因可以安全有效地应用于宫腔镜手术。
[Abstract]:Objective to observe the effect of intravenous lidocaine under Narcotrend anesthesia depth index in hysteroscopic surgery.Methods Eighty patients undergoing elective hysteroscopic surgery were randomly divided into normal saline group (S group) and lidocaine group (L group). Before anesthesia induction, lidocaine was injected intravenously for 1.5 mg/kg.Then 2 mg/(kg / h) was continuously infused to group S after operation, and the same volume of normal saline was given.NT was used to monitor the depth of anesthesia, propofol and remifentanil were used in both groups.The postoperative visual analogue scores (VAS), the incidence of pharynx and larynx pain, the adverse reactions of lidocaine and the incidence of pharynx and larynx pain were recorded in the two groups during the operation time and the total amount of propofol and remifentanil.Results there was no significant difference in the age, body weight and the total amount of propofol between the two groups. The dosage of remifentanil in group L was significantly lower than that in group S (P 0.05).At rest, the VAS score in group L was lower than that in group S (P 0.05), but there was no significant difference between group T _ 5 and T _ P _ 5 at T _ 3 / T _ 4.The incidence of pharyngeal and laryngeal pain in group L was significantly lower than that in group S (P 0.05). There was no adverse reaction of lidocaine in group L.Conclusion Lidocaine monitored by Narcotrend can be used safely and effectively in hysteroscopic surgery.
【作者单位】：武汉大学人民医院麻醉科;
【基金】：中央高校基本科研业务费专项基金(编号:2042017kf0144)
【分类号】：R614

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