盐酸利多卡因胶浆尿道麻醉的临床试验

用亚太盐酸利多卡因胶浆２％２０ｇ对１００例男性患（年龄４９±ｓ１０ａ）与Ａｓｔｒａ盐酸利多卡因胶浆２％２０ｇ对６０例男性患（年龄５１±８ａ）进行尿道表面麻醉作对比。结果临床有效率分别为９４％与１００％（Ｐ＞０．０５）。未见明显不良反应。     

盐酸达克罗宁胶浆在尿道局部麻醉中的临床应用

目的 观察盐酸达克罗宁胶浆在尿道局部麻醉中的临床应用效果.方法 将重庆三峡中心医院2011年8月至2012年4月行膀胱镜检的男性患者400例完全随机分为观察组和对照组,各200例.观察组于术前尿道内灌注涂抹盐酸达克罗宁胶浆,达克罗宁润滑镜鞘;对照组于术前尿道内灌注涂抹利多卡因注射液,石蜡油润滑镜鞘;观察2组的疼痛差异、不良反应发生情况.结果 观察组的麻醉有效率为93％(186/200),明显高于对照组[80％ (160/200)],差异有统计学意义(P＜0.05);2组患者均无严重不良反应发生.结论 盐酸达克罗宁胶浆可安全地用于尿道局部麻醉且麻醉作用强,润滑效果好,是术前尿道麻醉的理想用药.     

盐酸利多卡因胶浆在胃镜检查中的麻醉效果分析

目的观察盐酸利多卡因胶浆含服与传统地卡因咽部喷雾麻醉对比的优越性,明确胃镜检查局部麻醉中盐酸利多卡因胶浆的作用和地位。方法随机将4616例胃镜检查局麻患者分为利多卡因胶浆含服组与地卡因咽部喷雾组,对表面麻醉效果进行双盲对照研究。结果在对咽部刺激、插镜反应、唾液量、泡沫量和胃蠕动单项观察指标和综合效果评定指标上利多卡因胶浆组均优于地卡因组。结论利多卡因胶浆集麻醉、润滑、祛泡、安全等作用于一体,含服给药对咽反射阻断效果好,且术中分泌物少,视野清晰,胃蠕动减少,使用方便、简单,是一种优于地卡因喷雾麻醉的胃镜检查局部麻醉方法。     

盐酸达克罗宁胶浆联合利多卡因在表面麻醉下经尿道输尿管镜置入输尿管导管中的应用效果

目的 探讨盐酸达克罗宁胶浆联合利多卡因在表面麻醉下经尿道输尿管镜置入输尿管导管中的应用效果。方法 选取2021年9月至2022年5月在赣州市肿瘤医院接受表面麻醉下经尿道输尿管镜置入输尿管导管的共计80例患者作为研究对象,按照随机数字表法分成研究组（40例）与对照组（40例）,对照组给予利多卡因麻醉,研究组在对照组基础上联合盐酸达克罗宁胶浆麻醉,比较两组患者躁动情况、疼痛程度、生命体征及应激反应。结果 研究组患者的躁动发生率低于对照组,差异有统计学意义（P<0.05）;研究组患者的疼痛发生率低于对照组,差异有统计学意义（P<0.05）;整体分析发现：心率（HR）、平均动脉压（MAP）组间比较、时间点比较及交互作用比较,差异均有统计学意义（P<0.05）,进一步两两比较,两组患者术后3、6 h的HR快于术前、MAP高于术前,两组患者术后6 h的HR慢于本组术前3 h、MAP低于本组术前3 h,差异有统计学意义（P<0.05）。研究组患者术后3、6 h的HR慢于对照组同期、MAP低于对照组同期,差异有统计学意义（P<0.05）;肾上腺素（E）、去甲肾上腺素（NE...     

碳酸利多卡因与盐酸利多卡因在拔牙术中的麻醉效果比较

在拔牙术中,分别用碳酸利多卡因及盐酸利多卡因行局部麻醉100例,观察其麻醉效果。显示碳酸利多卡因潜伏期为54.00±10.20s;盐酸利多卡因潜伏期为200.00±9.50s,有显著差异(P<0.01)。表明碳酸利多卡因与盐酸利多卡因比较,前者潜伏期短,麻醉效能强。     

HPLC测定盐酸利多卡因胶浆中盐酸利多卡因的含量

目的建立盐酸利多卡因胶浆中盐酸利多卡因含量的测定方法。方法高效液相色谱法。采用SunFire C18柱(4.6mm×150mm,3.5μm),流动相为磷酸盐缓冲液(调节pH值至8.0)-乙腈(50∶50),检测波长为254nm。结果此方法线性关系良好,平均加样回收率为100.9%。结论此方法简便、准确,可用于测定盐酸利多卡因胶浆中盐酸利多卡因含量的含量。     

盐酸利多卡因胶浆与盐酸丁卡因胶浆胃镜检查术前应用效果比较

目的比较盐酸利多卡因胶浆与盐酸丁卡因胶浆在胃镜检查术前的应用效果。方法将胃镜检查患者按检查日期单双号分为利多卡因组188例与丁卡因组173例,检查前分别含服盐酸利多卡因胶浆和盐酸丁卡因胶浆行表面麻醉,比较两组患者胃镜检查时恶心程度、镜下视野清晰度和检查时间。结果两组胃镜检查时恶心程度接近,差异无统计学意义;镜下视野清晰度利多卡因组好于丁卡因组,检查时间利多卡因组短于丁卡因组,差异均有高度统计学意义。结论两种麻醉药均能减轻患者胃镜检查时的恶心感,但盐酸利多卡因胶浆能够增强胃镜检查时的视野清晰度,缩短胃镜检查时间,且价格低廉,性价比高。     

盐酸利多卡因胶浆在人流手术前的应用

我院今年在人工流产术采用盐酸利多卡因胶浆 (商品名为抒利)进行宫颈注入取得良好效果 ,现报道如下。１资料与方法１ １观察对象 :将今年来我院门诊要求人工流产的早孕妇女２００例 ,年龄在１８岁～４５岁之间 ,停经在４５天～５０天。随机分成实验组和对照组各１００例 ,两组年龄及孕龄具有可比性。两组术前均常规行妇科检查 ,确诊早孕排除宫颈急性炎症及阴道炎症和妇科肿瘤。１ ２方法 :实验组在外阴及阴道常规消毒铺巾 ,并消除宫颈管内分泌物后 ,将盐酸利多卡因胶浆涂布于颈管内口 ,１分钟后即可手术。对照组只给予口头安慰。宫颈扩张及…     

Optimization of lidocaine application in tumescent local anesthesia

Tumescent local anesthesia is based upon the infusion of large volumes of neutralized anesthetic solutions, mainly lidocaine, at very low concentrations. This results in the paralysis of sensory nerve endings and minute nerve twigs, leading to a reduction in pain. The aim of this study was to assess the safety of lidocaine application in tumescent local anesthesia on different regions of patient’s bodies. Measures of safety included the analysis of lidocaine concentrations and its pharmacokinetic parameters. In total, 48 patients were infused with tumescent anesthesia in the hypogastrium, buttocks and thighs, axillae, breasts, trunk, and face and neck areas. Lidocaine was infused in doses ranging from 5.2–40 mg/kg b.w., and in concentrations of 0.05% (hypogastrium, buttocks, thighs) or 0.1–0.15% (axillae, breasts, trunk, face, neck), using a total amount of 300–3200 mg. As the peak lidocaine concentration did not exceed 5 μg/ml (commonly known as the toxic threshold), the results of our study indicate that the doses used (not exceeding 40 mg/kg b.w.) are completely safe for patients undergoing tumescent anesthesia in different body areas. The observation of statistically significant correlations between both the dose and the total amount of lidocaine administered and its peak plasma concentration, together with the lack of correlations between the dose and the amount and the time taken to reach peak concentration, allows the safety of each anesthetic dose to be predicted. An analysis of the heterogeneous dynamics of lidocaine plasma concentration changes in tumescent anesthesia in different body areas indicates that both the rates and the degrees of absorption and elimination depend on the area of infiltration; this is in turn related to the vascularization of any given area. The study of lidocaine concentration and pharmacokinetic parameters also showed that there may potentially be a higher risk of a large anesthetic concentration developing within a short period of time during anesthesia of the upper parts of the body. During tumescent anesthesia, significantly higher plasma concentrations of lidocaine were observed in the face and neck than in the hypogastrium, buttocks and thighs, axillae, breast and trunk 0.5 to 4 h after its infusion. This indicates the need for carefully conducted patient observations immediately after infiltration into the aforementioned areas.     

Safety and efficacy of various concentrations of topical lidocaine gel for intravitreal injection

Introduction: Intravitreal injection (IVT) is one of the most common vitreoretinal procedures, a large majority are performed with local anesthesia. The purpose of this study was to investigate the safety to the cornea and anesthetic efficacy of five concentrations of lidocaine gel.

Methods: A prospective clinical trial was conducted testing lidocaine gel in five preparations: 2, 3.5, 5, 8 and 12%. Patients with macular degeneration, diabetic edema or retina vein occlusion were scheduled for intravitreal treatment received topical anesthesia with lidocaine gel 5 and 10 min before the procedure. Patients answered the visual analog scale for pain during the procedure. Corneal and conjunctival was evaluated using the Oxford scale.

Results: In total, 260 patients were randomized into five groups. The mean pain scores (± standard deviation) were 2.63 (± 1.68) in the 2% group, 2.08 (± 1.35) in the 3.5%; 2.00 (± 1.65) in the 5%, 1.93 (± 1.40) in the 8% and 1.83 (± 1.35) in the 12% group. Mean pain score among all groups was similar (p = 0.077). There was no significant difference between groups in regard to keratitis mean score (p = 0.897).

Conclusions: Lidocaine gel at concentrations from 2 to 12% induced similar anesthetic effect for IVTs, without adverse effects on cornea and conjunctiva.     

高效液相色谱法测定林可霉素利多卡因凝胶中盐酸利多卡因的含量

目的:采用高效液相色谱法测定林可霉素利多卡因凝胶中盐酸利多卡因的含量.方法:采用Hypersil C18色谱柱(200mm×4.6mm,5μm),以甲醇-0.25 mol·L-1醋酸钠溶液-乙腈(55:26:19)为流动相,流速1.0mL·min-1,紫外检测波长:230nm.外标法峰面积定量.结果:样品与凝胶基质分离良好,线性范围为59.41～138.63 mg·L-1,样品溶液在24 h内稳定,平均加样回收率为99.7%,RSD为0.19%(n=9).结论:本法简便、快速,结果准确、可靠,重现性好.     

两种利多卡因及布比卡因用于剖宫产时硬膜外麻醉的比较观察

目的:观察1.73%碳酸利多卡因与2%盐酸利多卡因、0.5%布比卡因用于剖宫产时硬膜外麻醉的临床效果。方法:259例需做剖宫产手术的病人,随机分别接受1.73%碳酸利多卡因(碳利组,n=88),2%盐酸利多卡因(盐利组,n=91)和0.5%布比卡因(布比组,n=80),观察感觉阻滞(针刺法),运动阻滞(改良Bromage评分),术中疼痛(VAS评分),镇痛和腹壁肌松质量,心血管指标及不良反应。结果:碳利组在麻醉显效和痛觉完全消失的时间上明显短于盐利组和布比组(P<0.05);在麻醉作用持续时间上,碳利组和盐利组无明显差异,但明显短于布比组(P<0.05);碳利组术前及术中阻滞平面达T6病例百分比高于盐酸组和布比组(P<0.01￣0.001);平面达T6所需时间也明显短于盐利组和布比组;碳利组首剂后10分钟出现运动阻滞病例的百分比高于布比组和盐利组(P<0.05),而30分钟时无明显差异;术后运动阻滞完全恢复时间碳利组明显短于布比组,与盐利组无显著差异;碳利组的术中疼痛(VAS)评分低于盐利组和布比组(P<0.05￣0.01);镇痛和腹壁肌松质量优于盐利组和布比组(P<0.05￣0.01);观察中无严重不良反应。结论:1.73%碳酸利多卡因用于剖宫产硬膜外麻醉时,其感觉阻滞及镇痛、肌松效果优于2%盐酸利多卡因和0.5%布比卡因,运动阻滞起效快且较完善,同时恢复迅速。     

异丙酚静脉麻醉期间利多卡因临床药动学

目的研究异丙酚靶控输注静脉全麻下恒速输注不同速率利多卡因时机体吸收、分布、代谢情况。方法选择18例异丙酚静脉全麻手术患者,麻醉稳定后随机输注利多卡因0.15 mg·kg~(-1)·min~(-1)(组Ⅰ,n=9)或0.20 mg·kg~(-1)·min~(-1)(组Ⅱ,n=9)。利多卡因注药后和停药后不同时间分别抽取桡动脉血,应用HPLC-UV法检测利多卡因血浆浓度,DAS软件包计算药动学参数。结果利多卡因注射后血药浓度-时间曲线可用开放性二室模型描述,2组患者利多卡因药动学参数除AUC_((0-65))外差异均无统计学意义(P·0.05):t_(1/2α)为(2.701±2.346)min,t_(1/2β)为(53.508±25.111)min,V_1/F为(0.251±0.151)L·kg~(-1),EL为(6.704±5.098)mL·min~(-1)·kg~(-1),k_(10)为(0.019±0.005)·min~(-1),k_(12)为(0.038±0.023)·min~(-1),k_(21)为(0.195±0.158)·min~(-1)。t_(1/2α)、t_(1/2β)、V_1、CL、k_(10)、k_(12)、k_(21)的RSD分别为86.85%、46.93%、60.10%、76.04%、26.07%、60.55%和80.80%。结论临床应用利多卡因不同输注速率对药动学无明显影响。与异丙酚联合用于全麻患者时利多卡因参数个体差异较大,静脉麻醉靶控输注时应注意个体化用药。     

3%氯普鲁卡因用于低位硬膜外麻醉的临床观察

目的比较3%氯普鲁卡因和2%利多卡因低位硬膜外麻醉的临床效果。方法 40例行下腹部手术患者,随机分成2组,每组20例。对照组:2%利多卡因;试验组:3%氯普鲁卡因。行连续低位(L1～2)硬膜外麻醉。观察感觉阻滞起效时间、感觉阻滞平面上界、运动阻滞起效时间、运动阻滞程度及麻醉质量。结果试验组感觉阻滞起效时间明显快于对照组(P<0.05)。感觉阻滞平面上界2组差异无统计学意义(P>0.05)。运动阻滞起效时间试验组明显快于对照组(P<0.05),但2组Bromage评分在1分以上之和的差异无统计学意义(P>0.05)。对照组和试验组麻醉质量0加1分所占例数的百分比分别为80%和85%(P>0.05)。对照组和试验组患者收缩压在感觉阻滞平面达上界及运动阻滞起效时均明显降低(P<0.05),在整个手术过程中HR和DBP无明显改变(P>0.05)。2组患者术前、术后24h血生化指标差异无统计学意义(P>0.05)。结论 3%盐酸氯普鲁卡因用于低位硬膜外麻醉感觉、运动阻滞起效快于2%利多卡因,但两种局麻药整体麻醉效能相似。     

Randomized clinical trial of two anesthetic techniques for intravitreal injections: 4% liquid lidocaine on cotton swabs versus 3.5% lidocaine gel

Objective: To compare same-day and next-day pain control and safety of two anesthetic techniques utilizing 4% liquid lidocaine applied with sterile cotton swabs versus 3.5% lidocaine gel for intravitreal injections. Main outcome measures were: discomfort during anesthetic preparation and needle penetration, 1 and 24 h after injection.

Methods: Patients were randomized to alternate anesthetic method at two consecutive injections in one eye or in different eyes on the same day if requiring bilateral injections. Overall satisfaction, corneal staining, and subconjunctival hemorrhage (SCH) were compared.

Results: Fifty patients were enrolled. Both methods resulted in similar mild discomfort during anesthetic preparation, 1 and 24 h later. The gel resulted in slightly higher discomfort during needle penetration (p = 0.026). Patients were satisfied with both techniques (p = 0.91), however, 52% patients preferred gel, 33% were indifferent, and 15% preferred cotton swabs (p = 0.002). There were significantly less corneal staining (p = 0.001) and SCH (p = 0.004) after the gel.

Conclusion: Both techniques are equally effective and yield mild discomfort scores during the procedure and the next day. The gel method results in significantly less ocular surface irritation.     

盐酸达克罗宁胶浆用于支气管镜检查术前局部麻醉患者的临床研究

目的 观察盐酸达克罗宁胶浆用于支气管镜检查术前局部麻醉患者的临床疗效及安全性.方法 将100例肺部病变患者随机分为对照组50例和试验组50例.对照组给予盐酸利多卡因注射液0.1 g/5 mL雾化吸入,试验组给予盐酸达克罗宁胶浆0.1 g/10 mL口含.比较2组患者的麻醉效果、盐酸利多卡因注射液总用量、患者满意率,以及...     

Adverse effects of topical anesthetics for dermatologic procedures

Introduction : Topical anesthetics are frequently used to decrease the pain associated with a variety of procedures including cutaneous surgery, cosmetic treatments and laser surgery. They are also routinely used in children prior to invasive procedures, such as venipuncture. The ideal topical anesthetic should safely increase patient comfort associated with these procedures with minimal potential for adverse effects.

Areas covered : Topical anesthetic formulations have evolved over the past several decades to include formulations with improved efficacy and side effect profiles [1 – 3]. However, significant adverse events are still possible.

Expert opinion : Medical practitioners can mitigate the risk of side effects and toxicity with careful selection of anesthetic type, concentration, body location and dermatologic procedure. Compounded formulations should be used with caution in medical settings only on limited body surface areas without occlusion. This review presents a detailed analysis of products available, reported complications and an outline for appropriate use of topical anesthetics in combination with dermatologic procedures.     

3.5%利多卡因眼用凝胶的研究进展

局部麻醉药在眼科的各类操作和手术中应用广泛,目前临床上使用的主要是表面麻醉药滴眼液。3.5%利多卡因眼用凝胶是眼科表面麻醉用新品,与表面麻醉药滴眼液相比,具有麻醉效果更好、有效麻醉作用时间更长、术中重复给药次数减少、角膜上皮毒性降低并能保护眼表等特性。本文介绍3.5%利多卡因眼用凝胶及其药代动力学、临床疗效和安全性方面的研究进展。