【罂粟摘要】 ERCP术前静注利多卡因对丙泊酚用量的影响： 一项前瞻性、随机、双盲研究
ERCP术前静注利多卡因对丙泊酚用量的影响：
一项前瞻性、随机、双盲研究
内窥镜逆行胰胆管造影术(ERCP)一般在合并症较多的患者中进行。本研究旨在通过在行ERCP前加入利多卡因来减少丙泊酚的用量。
将45~75岁的ASAⅠ~Ⅲ级的80例ERCP患者随机分为利多卡因组和对照组。利多卡因组(L组，n=40)，静脉注射咪达唑仑1mg、利多卡因1.5mg/kg、丙泊酚1mg/kg。对照组(C组，n=40)静脉注射咪达唑仑1mg，生理盐水（与利多卡因组体积相同），丙泊酚1mg/kg。丙泊酚以间歇性推注剂量给药。记录丙泊酚用量、口咽反射、苏醒时间、内窥镜医师满意度、氯胺酮需要量及其不良反应。
L组丙泊酚用量低于对照组(157.25 ± 39.16mg vs 228.75 ± 64.62mg, P<0.001)。此外，L组恢复时间明显快于对照组(分别为7.78 ± 3.95min和11.92±3.24min,P<0.001)。L组的口咽反射少于对照组（6/40 vs. 15/40, p=0.042）。两组患者在VAS评分和内窥镜医师满意度方面差异无统计学意义(p>0.05)。
我们建议在实施ERCP前静脉注射利多卡因，因为它可以减少丙泊酚的用量、恢复时间和口咽反射。
Pre-Procedure Intravenous Lidocaine Administration on Propofol Consumption for ERCP: A Prospective, Randomized, Double-Blind Study
ABSTRACT
Background and Aim: The endoscopic retrograde cholangiopancreatography (ERCP) procedure is generally performed in patients with high comorbidity. We aimed to reduce the consumption of propofol by adding lidocaine before ERCP.
Methods: Eighty ERCP patients with ASA I-III, aged between 45-75 years, were randomly divided into two groups. Lidocaine group (Group L,n=40), received 1mg midazolam, 1.5 mg/kg lidocaine, and 1 mg/kg propofol intravenously. The control group (Group C,n=40) received 1 mg midazolam, saline in the same volume as the lidocaine group, and 1 mg/kg propofol intravenously. Propofol was administered with intermittent bolus doses. Propofol consumption, oropharyngeal reflex, recovery time, endoscopist satisfaction, ketamine need, and side effects were recorded.
Results: Propofol consumption during the procedure was statistically lower in Group L than in the control group (157.25±39.16 mg vs. 228.75±64.62 mg respectively, p<0.001). Additionally, recovery time was statistically faster in group L compared to the control group (7.78±3.95 min vs. 11.92±3.24 min respectively, p<0.001). The oropharyngeal reflex was less in Group L than control group (6/40 vs. 15/40 respectively, p=0.042). There was no significant difference between the two groups regarding VAS scores and endoscopist satisfaction (p>0.05).
Conclusions: We recommend the use of intravenous lidocaine before the ERCP procedure as it reduces propofol consumption, recovery times, and oropharyngeal reflex.
原始文献来源：Ates I, Aydin ME, Albayrak B, et al. Pre-Procedure Intravenous Lidocaine Administration on Propofol Consumption for ERCP: A Prospective, Randomized, Double-Blind Study.[J] .J Gastroenterol Hepatol, 2020, undefined: undefined.
翻译：何幼芹
编辑：佟睿
审校：曹莹