利多卡因静脉泵注用于胃癌全身麻醉术后的镇痛效果

目的 比较利多卡因静脉泵注对胃癌全身麻醉术后的镇痛效果.方法 前瞻性选取2018年1月-2019年12月中国人民解放军联勤保障部队第九○○医院择期行全身麻醉下胃癌开腹手术的患者90例,采用随机数字表法分为利多卡因组(L组)、腹横肌平面阻滞(TAP)组(T组)和对照组(C组),每组30例.L组麻醉诱导前给予2％利多卡因负...

Analgesic effect of lidocaine intravenous pump for gastric cancer after general anesthesia

Objective To compare the analgesic effects of lidocaine intravenous pump on gastric cancer after general anesthesia.Methods From January 2018 to December 2019,90 patients who underwent elective open surgery for gastric cancer under general anesthesia at the 900 th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army were prospectively selected.Using random number table method,they were divided into lidocaine group(group L),TAP group(group T)and control group(group C),with 30 cases in each group.In group L,2%lidocaine was infused at the loading dose of 1 mg/kg before induction of anesthesia,and then the maintenance dose of 3 mg·kg^-1·h^-1 was injected to the end of the operation.In group T,TAP was blocked under ultrasound guidance after endotracheal intubation,20 ml ropivacaine hydrochloride was injected subcutaneously each side.In group C,same volume of saline as the lidocaine used in group L was injected intravenously.All the three groups were treated with patient-controlled intravenous analgesia(PCIA)with sufentanil2μg/kg and ketamine 2 mg/kg.Compared the visual analogue scale(VAS)score at 1 h(T₁),6 h(T₂),12 h(T₃),24 h(T₄)and 48 h(T5),PCIA pressing times,post-operative nausea and vomiting(PONV)times and occurrence of adverse reactions of three groups.Results There was no statistically significant difference in VAS scores between group L and group T at T₁,T₂,T₃,T₄,and T5(P>0.05).The VAS scores at T₁,T₂,T₃,and T₄ in group L and T were lower than those in group C(P<0.05);There was no significant difference in the number of PCIA between group L and the group T(P>0.05).The number of PCIA in group L and group T was lower than that of groupC(P<0.05);The incidence of PONV in group L and group T within 48 hours after operation was lower than that in group C,but the difference was not statistically significant(P>0.05).No serious adverse reactions occurred in the 3 groups of patients.Conclusion The analgesic effect of intravenous lidocaine infusion within 48 hours after general anesthesia for gastric cancer is comparable to that of ultrasound-guided TAP block,and there was no more adverse reaction in the treat dose.