利多卡因复合阿托品在无痛肠镜检查中的应用

目的:研究利多卡因复合阿托品在无痛肠镜检查时患者心血管反应及预防丙泊酚注射痛的效果。方法:选择要求进行无痛肠镜检查的患者60例,ASA1或2级,随机分为对照组(A组,n=30)、利多卡因复合阿托品组(B组,n=30)。A组直接注射丙泊酚1～1.5mg/kg及芬太尼0.5μg/kg,B组静脉推注利多卡因1mg/kg及阿托品0.01mg/kg,3min后注射丙泊酚1～1.5mg/kg及芬太尼0.5μg/kg。结果:A组在插镜时(T2)和检查3min时(T3)平均动脉压(MAP)与检查前(T1)比较,差异有统计学意义(P<0.01),检查3min(T3)时心率(HR)出现明显下降(P<0.05),B组患者给药后HR、MAP均较给药前升高,但差异无统计学意义(P>0.05),但B组患者丙泊酚的注射痛明显降低(P<0.05)。结论:麻醉前静脉注射利多卡因复合阿托品能降低无痛肠镜检查的心血管反应,并且能显著减轻丙泊酚的注射痛。

Application of lidocaine and atropine in painless colonoscopy

Objective：To observe the cardiovascular response in painless colonoscopy and the prevention effects of propofol injection pain when lidocaine composited with atropine were used in this process.Methods：Sixty patients at ASA grade 1 or 2 that chose to underwent painless colonoscopy were randomly divided into control group（group A,n=30）,and lidocaine composited with atropine group（group B,n=30）.Patients in group A were given injection of propofol（11.5 mg/kg）and fentanil（0.5 μg/kg）directly,while Group B were given intravenous injection of lidocaine（1 mg/kg）and atropine（0.01 mg/kg）3 minutes prior to the propofol（11.5 mg/kg）and fentanil（0.5 μg/kg）injection 3 min later.Results：In group A,patients＇ MBP significantly decreased when the fiber enteroscopy was inserted（T2）and the third minute（T3）of observation comparing with that before the surgery（P〈0.01）,HR also significantly decreased at T3（P〈0.05）.However,increace of patients＇ MBP and HR in group B at the corresponding time points were insignificant（P〉0.05）indicating propofol injection pain was alleviated significantly.Conclusion：Lidocaine composited with atropine can alleviate the cardiovascular response and prevent injection pain of propofol during colonoscopy.