围术期静脉注射利多卡因对腹腔镜胃成形术后疼痛强度及IL-6浓度的影响
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围术期静脉注射利多卡因对腹腔镜胃成形术后疼痛强度及IL-6浓度的影响
翻译：吴学艳 编辑：冯玉蓉 审校：曹莹
背景和目的：阿片类药物与镇静和呼吸抑制有关，本研究的首要观察指标是评估胃成形术中使用利多卡因后的疼痛强度；次要观察指标是评估IL-6浓度、吗啡用量、首次吗啡注射时间、拔管时间及副作用。
方法：将60例年龄18~60岁、ASA分级II-III级的减肥手术患者分为两组，麻醉诱导前5min；第1组给予1.5 mg/kg的利多卡因，第2组给予等体积0.9%NS；在手术过程中；第1组输注利多卡因(2 mg/kg/h)，第2组则给以等量0.9%NS。麻醉采用芬太尼(5μg/kg)、异丙酚、罗库溴铵和七氟烷。术后患者使用吗啡自控镇痛。评估疼痛强度、IL-6浓度、24小时吗啡用量、首次吗啡注射时间、拔管时间及不良反应。
结果：利多卡因组术后一小时内疼痛强度低于对照组，IL-6浓度及拔管时间组间无差异。利多卡因组24小时内吗啡用量较少、首次吗啡注射时间延长，恶心发生率更低。
结论：利多卡因可降低术后早期疼痛强度、恶心发生率及24小时内吗啡用量，延长首次吗啡注射时间，但不降低血浆IL-6浓度。
原始文献来源: de Oliveira CMB, Coelho LMG, Valadão JA, et al.Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty.[J].Obes Surg 2020 Oct;3010(10).
Assessment of the Effect of Perioperative Venous Lidocaine on the Intensity of Pain and IL-6 Concentration After Laparoscopic Gastroplasty
Abstract
Background and Objectives: Opioids are associated with sedation and respiratory depression. The primary objective of this study was to assess pain intensity after gastric bypass with lidocaine. The secondary objective was to assess the IL-6 concentration,consumption of morphine, time to morphine request, time to extubation, and side effects.
Methods: Sixty patients aged 18 to 60 years, with ASA (American Society of Anesthesiologists) scores of 2 or 3, who underwent bariatric surgery were allocated to two groups. Patients in group 1 were administered lidocaine (1.5 mg/kg) 5 min before the induction of anesthesia, and group 2 was administered 0.9% saline solution in an equal volume. Subsequently, lidocaine (2 mg/kg/h) or 0.9% saline was infused during the entire surgical procedure. Anesthesia was performed with fentanyl(5μg/kg), propofol, rocuronium, and sevoflurane. Postoperative patient-controlled analgesia was provided with morphine.The following were evaluated: pain intensity, IL-6, 24-h consumption of morphine, time to the morphine request, time to extubation, and adverse effects.
Results: The lidocaine group had a lower pain intensity than the saline group for up to 1 h, with no differences between groups in IL-6 and time to extubation. The lidocaine group consumed less morphine within 24 h, had a longer time until the first supplemental morphine request, and had a lower incidence of nausea.
Conclusions: Lidocaine reduced the intensity of early postoperative pain, incidence of nausea, and consumption of morphine within 24 h and increased time to the first morphine request, without reducing the plasma concentrations of IL-6.
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