静脉预注利多卡因对顺式阿曲库铵肌松起效时间的影响

目的观察麻醉诱导期间静脉预注利多卡因对顺式阿曲库铵肌松起效时间的影响。方法选择ASAI～II级气管插管全麻下择期手术患者60例,随机分为利多卡因组和对照组,每组各30例。给予异丙酚和芬太尼全麻诱导,并采用加速度法四个成串刺激(TOF)监测肌松。利多卡因组静注利多卡因1.5mg/kg,对照组静注等量0.9%氯化钠注射液,2min后两组都静注顺式阿曲库铵0.15mg/kg,记录肌松起效时间(注药结束至TOF的T1肌颤搐抑制95%的时间)及气管插管条件。结果肌松起效时间:利多卡因组与对照组分别为(116.12±29.31)s、(210.13±33.11)s,利多卡因组明显快于对照组,差异有统计学意义(t=11.65,P<0.05)。气管插管条件:利多卡因组也明显优于对照组,差异有统计学意义(Zc=2.90,P<0.05)。结论利多卡因明显缩短顺式阿曲库铵肌松起效时间、改善气管插管条件,有助于增加顺式阿曲库铵的临床适用范围。

Effects of intravenous lidocaine pretreatment on onset time of cisatracurium-induced neuromuscular block

Objective To investigate the effects of intravenous lidocaine pretreatment on onset time of cisatracurium-induced neuromuscular block during induction of anesthesia.Methods Sixty ASA I or II patients undergoing elective surgery under general anesthesia were randomly divided into 2 groups（n=30 each）：group lidocaine and group control.Anesthesia were induced with propofol and fentanyl.Neuromuscular function was monitored and recorded using acceleromyography.An intravenous bolus of lidocaine 1.5 mg/kg was given to group lidocaine while the equivalent volume of 0.9% sodium chloride injection to group control.Two minutes later cisatracurium 0.15 mg/kg was injected as a bolus.The cisatracurium onset time（from the end of injection of cisatracurium until 95% depression of T1） and tracheal intubating conditions were recorded.Results The onset time of neuromuscular block induced by cisatracurium in group lidocaine was（116.12±29.31）s compared with（210.13±33.11）s in group control,which was significantly faster（t=11.65,P〈0.05）.The intubating conditions in group lidocaine were significantly better than that in group control（Zc=2.90,P〈0.05）.Conclusions Intravenous lidocaine pretreatment shortens the onset time of cisatracurium,improves endotracheal intubating conditions.Lidocaine is an effective ancillary drug for cisatracurium-induced tracheal intubation and contributes to expanding the scope of clinical application.