利多卡因加肾上腺素对安置永久性人工心脏起搏器的影响

目的 观察利多卡因加肾上腺素对安置永久性人工心脏起搏器患者皮下囊袋血肿及安全性方面的影响.方法 将46例行永久性人工心脏起搏器植入术的患者随机分为实验组和对照组,每组23例.实验组用2%利多卡因25 ml加肾上腺素0.1 mg局麻做皮下囊袋,对照组用2%利多卡因25 ml局麻做皮下囊袋.比较两组患者皮下囊袋血肿、心率、血压及心律失常的发生情况.结果 （1）实验组无皮下囊袋血肿发生,对照组有3例囊袋血肿.（2）两组患者心率、血压、心律失常发生率在局麻前后无明显变化（P〉0.05）,两组患者均无致命性心律失常发生.结论 利多卡因加小剂量肾上腺素可减少安置永久性人工心脏起搏器患者皮下囊袋血肿的发生,但对心率、血压、心律失常发生方面无明显影响,是安全可行的.

The effect of lidocaine combined with epinephrine on implantation of permanent cardiac pacemaker

Objective To study the effect of lidocaine combined with epinephrine on pocket hematoma after implantation of permanent cardiac pacemaker and its safety. Methods 46 patients implanting permanent cardiac pacemaker were randomly divided into two groups. 23 patients were injected with 2% lidocaine 25ml and epinephrine 0. 1 mg while 23 patients were injected with 2% lidocaine 25 ml only at the operative site of subcutaneous pacemaker pocket. Pocket hematoma, heart rate（HR） ,blood pressure （BP） and arrhythmia were compared between the two groups before and after anesthesia. Results （ 1 ） There were three cases of pocket hematoma in the control group patients and there was no case of it in the test group. （2） There were no significant differences in HR, BP and arrhythmia between the two groups before and after anesthesia （ P 〉 0. 05 ）. There was no fatal arrhythmia in the two groups. Conclusion The application of epinephrine combined with lidocaine during implantation of permanent cardiac pacemaker is safe and can reduce pocket hematoma with no side effect on HR,BP and arrhythmia.