预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的半数有效量

谭潮; 吴浩; 于乐洋; 严诗婷; 王莹; 田顺平; 周炜; 眭伟; 张转

doi:10.7619/jcmp.20212278

预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的半数有效量

Median effective dose of intravenous lidocaine in advance in preventing propofol medium/long chain triglyceride emulsion injection-induced pain

摘要

摘要:
目的确定预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的半数有效剂量（ED₅₀）。
方法选取择期全麻手术患者美国麻醉医师协会（ASA）分别Ⅰ或Ⅱ级。在患者使用丙泊酚中/长链脂肪乳之前，预先静脉注射利多卡因，初始剂量为0.5 mg/kg瘦体质量（LBW）。根据注射痛程度采用Dixon序贯法行利多卡因剂量调整。记录注射痛情况及不良反应发生情况。计算利多卡因的ED₅₀及95%CI。记录麻醉后监测治疗室（PACU）内患者对注射痛的记忆情况并行视觉模拟评分量表（VAS）评估。
结果共30例患者完成试验，其中有效止痛患者19例，无效患者11例。预先静脉注射利多卡因预防丙泊酚中/长链脂肪乳注射痛的ED₅₀为0.306 mg/kg（95%CI：0.262~0.357 mg/kg）LBW。90.9%发生注射痛的患者在PACU内对注射痛有记忆，VAS评分为（2.8±1.8）分。
结论预先静脉注射利多卡因0.306 mg/kg LBW可有效预防50.0%的择期全麻手术患者丙泊酚中/长链脂肪乳注射痛，且无不良反应。

Abstract:
Objective To ensure the median effective dose (ED₅₀) of intravenous lidocaine in advance in preventing propofol medium-/long-chain triglyceride emulsion injection pain.
Methods Patients for elective surgery undergoing general anesthesia American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱwere selected. Lidocaine was administered intravenously prior to propofol medium-/long-chain triglyceride at an initial dose of 0.5 mg/kg lean body mass (LBW). The dose of lidocaine was adjusted by Dixon sequential method according to injection pain. Injection pain and adverse reactions were recorded. The ED₅₀ and 95%CI of lidocaine were calculated. Patients'memory of injection pain in postanesthesia care unit (PACU) was recorded and Visual Analogue Scale (VAS) was evaluated.
Results A total of 30 patients completed the trial, including 19 patients with effective pain relief and 11 patients with ineffective pain relief. The ED₅₀ of lidocaine in advance to prevent propofol medium-/long-chain triglyceride emulsion injection pain was 0.306 mg/kg (95%CI, 0.262 to 0.357 mg/kg) LBW. In PACU, 90.9% of the pain-experienced patients had memory of injection pain, and VAS score was (2.8±1.8).
Conclusion Prophylactic intravenous lidocaine for 0.306 mg/kg LBW could effectively prevent propofol medium-/long-chain triglyceride emulsion injection pain in 50.0% of patients for elective surgery undergoing general anesthesia without adverse reactions occurred.

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