| 魏本忠,曹小飞.利多卡因复合小剂量氯胺酮静脉输注在老年患者无痛膀胱镜检查中的应用[J].安徽医药,2018,22(11):2227-2229. |
| 利多卡因复合小剂量氯胺酮静脉输注在老年患者无痛膀胱镜检查中的应用 |
| Application of lidocaine combined with small-dose of ketamine for painless cystoscopy in elderly patients |
| 投稿时间：2016-10-21 |
| DOI： |
| 中文关键词: 利多卡因 无痛膀胱镜 丙泊酚 氯胺酮 |
| 英文关键词: Lidocaine Painless cystoscopy Propofol Ketamine |
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| 中文摘要: |
| 目的 探讨利多卡因复合小剂量氯胺酮超前镇痛在无痛膀胱镜检查中的应用效果。方法 选择2013年6月至2015年6月于南京鼓楼医院集团仪征医院50例行无痛膀胱镜检查的老年患者,按随机数字表法将其分为利多卡因＋小剂量氯胺酮组(L组)和单纯丙泊酚组(P组),每组25例。L组:检查开始时静脉注射0.4 mg·kg-1氯胺酮+2％利多卡因1.5 mg·kg-1后,然后持续泵注氯胺酮5 μg·kg-1·min-1+利多卡因1 mg·kg-1·h-1。P组:检查开始时静脉注射丙泊酚2～3 mg·kg-1,然后以6～10 mg·kg-1·h-1持续泵注。记录麻醉诱导时间、膀胱镜检查时间、术后苏醒时间；记录心率、血压等生命体征的变化；记录术中体动反应、呼吸暂停、心动过缓、低血压等术中及术后有关并发症的发生情况。结果 L组患者术中心率及血压最低值分别为每分钟(69.3±7.7)次、(68.6±8.5)mmHg,较P组患者每分钟(64.6±7.1)次、(64.1±6.7)mmHg明显降低(P=0.03,0.04)；L组患者术中体动反应、低氧血症、注射痛及术后头晕、尿道疼痛的发生例数较P组明显降低,差异有统计学意义(P<0.05)。结论 利多卡因复合小剂量氯胺酮组在老年患者无痛膀胱镜检查中具有良好效果,并可明显降低术中不良反应发生率。 |
| 英文摘要: |
| Objective To evaluate the efficacy of lidocaine combined with preemptive analgesia by small-dose ketamine for the elderly patients undergoing painless cystoscopy.Methods In a double-blind study,50 patients undergoing painless cystoscopy in Yizheng hospital of Nanjing Gulou Hospital Group from June 2013 to June 2015 were randomized into 2 groups:Propofol group (n=25,group P) and lidocaine combined with small-dose ketamine group (n=25,group L).In group P,propofol 6 to 10 mg·kg-1·h-1 was injected iv continuously after induction of anesthesia by propofol 2 to 3 mg·kg-1 injection.In group L,ketamine and lidocaine were continuously infused at the speed of 5 μg·kg-1·min-1 and 1 mg·kg-1·h-1 following lidocaine 1.5 mg·kg-1 intravenous injection ten minutes before the operation plus ketamine 0.4 mg·kg-1 intravenous injection.Heart rate (HR),mean arterial pressure (MAP),anesthesia induction time,cystoscopy time,recovery time,intraoperative body movement,apnea,bradycardia,hypotension,and other postoperative complications were recorded.Results Compared with group P,the change scales of HR and MAP in group Lwere smaller [(69.3±7.7) vs.(64.6±7.1);(68.6±8.5) mmHg vs.(64.1±6.7) mmHg;P=0.03,0.04].The incidences of postoperative physical activity,hypoxemia,injection pain,dizziness and urethral pain after operation in group Lwere significantly lower than those in group P;the differences were statistically significant (P<0.05).Conclusion Lidocaine combined with small-dose ketamine has good effects on painless cystoscopy of elderly patients,which can significantly decrease the incidences of intra-and post-operative complications. |
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