不同剂量利多卡因联合丙泊酚在无痛胃镜中的应用研究

目的 探讨利多卡因联合丙泊酚应用于无痛胃镜检查与治疗的最适宜浓度及剂量.方法将800例行胃镜检查与治疗的患者随机分为4组,A组100例,采用0.33%丙泊酚沣射液缓慢静脉注射麻醉;B组200例,采用浓度<0.1%,剂量为(0.1-0.5)mg·kg-1的利多卡因联合0.33%丙泊酚注射液缓慢静脉注射麻醉;C组400例,采用浓度为0.1%-0.15%,剂量为(0.5-1.0)mg·kg-1的利多卡因联合0.33%丙泊酚注射液缓慢静脉注射麻醉;D组100例,采用浓度为0.15%-0.20%,剂量为(10.-1.5)mg·kg-1的利多卡因联合0.33%丙泊酚注射液缓慢静脉注射麻醉.记录各组用药时局部刺激反应、术中体动情况、呼吸暂停、丙泊酚用量、术后苏醒时间及心电监测仪监测结果.结果 4组血压、血氧饱和度、心率、呼吸频率等变化均在正常范围内,均未发生呼吸暂停.C组与D组局部刺激反应发生率、术中体动发生率、丙泊酚应用剂量均显著低于A组与B组(P<0.05或0.01);C组术后苏醒时间显著快于A组、B组和D组(P<0.01),血压、血氧饱和度,心率、呼吸频率波动幅度

Application research on different doses of lidocaine plus propofol for painless gastroscopy

Objective To explore the optimum concentration and dosage of lidocaine plus propofol for painless gastroscopy and treatment. Methods 800 patients receiving gastroscopies and treatment were randomly divided into four groups, group A （n= 100） anesthetized with slowing intravenous injection of 0.33% propofol injection; group B （n=200） with lidocaine （concentration 〈0.1%, 0.1-0.5 mg/kg plus slowing intravenous injection of 0.33% propofol; group C （n=400） with lidocaine （0.1%-0.15%, 0.5-1.0 mg/kg） plus slowing intravenous injection of 0. 33% propofol; group D （n= 100） with lidocaine （0.15%-0.20%, 1.0%1.5 mg/kg） plus slowing intravenous injection of 0.33% propofol. Such parameters were recorded as local stimulus response, intraoperative body＇s movement, apnea, propofol dosage, postoperative recovery time and electrocardioscanner monitoring results. Results Changes of BP, blood oxygen saturation, HR and respiratory rate of all 4 groups were in normal range and all 4 groups didn＇t develop apnea. The incidences of local stimulus response and intraoperative body＇s movement and propofol dosage were significantly lower in group C and D than in A and B （P〈0.05 or 0.01） ; the postoperative recovery time was significantly shorter （P〈0.01） and the fluctuation range of BP, blood oxygen saturation, HR and respiratory rate smaller in group C than A, B and D. Conclusion Lidocaine＇s optimum concentration and dosage combined with propofol for painless gastroscopy and treatment are 0.1-0.15 percent and O. 5-1.0 mg/kg, patients＇ vital signs stable and safety higher at this time.