Effects of Intravenous Lidocaine on Propofol Anesthesia for Painless Gastroscopy_West China Medical Journal

Authors：

XUE Ying ,  LIU Jin.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Jin., Email: seolyeong86@gmail.com

Keywords：

静脉利多卡因; 异丙酚; 无痛胃镜检查

DOI：

10.7507/1002-0179.20130271

Video：

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目的　探究静脉利多卡因联合异丙酚在无痛胃镜麻醉应用中的可行性、安全性和有效性。方法　纳入2012年4月－5月行无痛胃镜检查的患者102例，随机分为两组：利多卡因组（L组）和生理盐水组（S组）。L组于麻醉诱导前缓慢静注2%利多卡因2 mg/kg，S组给予相同容量的生理盐水。比较两组间的异丙酚诱导剂量、追加剂量和总量，以及检查中呛咳反应、体动的发生率，麻醉时间，不良事件和不良反应发生率，麻醉医生和患者满意度是否有差异。结果　 L组较S组异丙酚诱导剂量减少约0.17 mg/kg，差异有统计学意义（P=0.03）；余指标差异均无统计学意义。结论　将静脉利多卡因用于无痛胃镜麻醉，虽能减少异丙酚诱导剂量，但减少程度并不明显；不能改善诱导前后血流动力学的剧烈波动，也未能缩短总的麻醉时间；在抑制术中呛咳反应、体动方面也未见明显优势。无论是从安全性还是经济学方面考虑，我们都不推荐将静脉利多卡因联合异丙酚麻醉的方案用于无痛胃镜检查。

Citation： XUE Ying,LIU Jin.. Effects of Intravenous Lidocaine on Propofol Anesthesia for Painless Gastroscopy. West China Medical Journal, 2013, 28(6): 864-867. doi: 10.7507/1002-0179.20130271 Copy

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2.	Sebel PS, Lowdon J D. Propofol: a new intravenous anesthetic[J]. Anesthesiology, 1989, 71(2): 260-277.
3.	米勒. 米勒. 麻醉学·上卷[M]//曾因明, 邓小明, 译. 6版. 北京：北京大学医学出版社, 2006: 324-330.
4.	Cressey DM, Bhaskaran NC, Reilly CS. Effect of midazolam pretreatment on induction dose requirements of propofol in combination with fentanyl in younger and older adults[J]. Anaesthesia, 2001, 56(2): 108-113.
5.	Bailey PL, Pace NL, Ashburn MA, et al. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl[J]. Anesthesiology, 1990, 73(5): 826-830.
6.	Himes RS Jr, DiFazio CA, Burney RG. Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane[J]. Anesthesiology, 1977, 47(5): 437-440.
7.	Kaba A, Laurent S R, Detroz B J, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy[J]. Anesthesiology, 2007, 106(1): 11-18.
8.	Kelsaka E, Karakaya D, Baris S, et al. Effect of intramuscular and intravenous lidocaine on propofol induction dose[J]. Med Princ Pract, 2011, 20(1): 71-74.
9.	Yukioka H, Yoshimoto N, Nishimura K, et al. Intravenous lidocaine as a suppressant of coughing during tracheal intubation[J]. Anesth Analg, 1985, 64(12): 1189-1192.
10.	Aouad, MT, Savvid SS, Zalaket MI, et al. Intravenous lidocaine as adjuvant to sevoflurane anesthesia for endotracheal intubation in children[J]. Anesth Analg, 2003, 96(5): 1325-1327.
11.	Baik H J, Kim Y J, Kim J H. Lidocaine given intravenously improves conditions for laryngeal mask airway insertion during propofol target-controlled infusion[J]. Eur J Anaesthesiol, 2009, 26(5): 377-381.
12.	Gaughen CM, Durieux M. The effect of too much intravenous lidocaine on bispectral index[J]. Anesth Analg, 2006, 103(6): 1464-1465.
13.	Punjasawadwong Y, Boonjeungmonkol N, Phongchiewboon A. Bispectral index for improving anesthetic delivery and postoperative recovery[J]. Anesth Analg, 2008, 106(4): 1326.
14.	Nordmark J, Rydqvist B. Local anaesthetics potentiate GABA-mediated Cl-currents by inhibiting GABA uptake[J]. Neuroreport, 1997, 8(2): 465-468.
15.	Moore JM, Liu SS, Neal JM. Premedication with fentanyl and midazolam decreases the reliability of intravenous lidocaine test dose[J]. Anesth Analg, 1998, 86(5): 1015-1017.

1. 　Classen M, Tytgat GNJ, Lightdale CJ. Gastroenterological endoscopy[M]. 2nd edition. Germany: Georg Thieme Verlag, 2010: 106-116.
2. 　Sebel PS, Lowdon J D. Propofol: a new intravenous anesthetic[J]. Anesthesiology, 1989, 71(2): 260-277.
3. 　米勒. 米勒. 麻醉学·上卷[M]//曾因明, 邓小明, 译. 6版. 北京：北京大学医学出版社, 2006: 324-330.
4. 　Cressey DM, Bhaskaran NC, Reilly CS. Effect of midazolam pretreatment on induction dose requirements of propofol in combination with fentanyl in younger and older adults[J]. Anaesthesia, 2001, 56(2): 108-113.
5. 　Bailey PL, Pace NL, Ashburn MA, et al. Frequent hypoxemia and apnea after sedation with midazolam and fentanyl[J]. Anesthesiology, 1990, 73(5): 826-830.
6. 　Himes RS Jr, DiFazio CA, Burney RG. Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane[J]. Anesthesiology, 1977, 47(5): 437-440.
7. 　Kaba A, Laurent S R, Detroz B J, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy[J]. Anesthesiology, 2007, 106(1): 11-18.
8. 　Kelsaka E, Karakaya D, Baris S, et al. Effect of intramuscular and intravenous lidocaine on propofol induction dose[J]. Med Princ Pract, 2011, 20(1): 71-74.
9. 　Yukioka H, Yoshimoto N, Nishimura K, et al. Intravenous lidocaine as a suppressant of coughing during tracheal intubation[J]. Anesth Analg, 1985, 64(12): 1189-1192.
10. 　Aouad, MT, Savvid SS, Zalaket MI, et al. Intravenous lidocaine as adjuvant to sevoflurane anesthesia for endotracheal intubation in children[J]. Anesth Analg, 2003, 96(5): 1325-1327.
11. 　Baik H J, Kim Y J, Kim J H. Lidocaine given intravenously improves conditions for laryngeal mask airway insertion during propofol target-controlled infusion[J]. Eur J Anaesthesiol, 2009, 26(5): 377-381.
12. 　Gaughen CM, Durieux M. The effect of too much intravenous lidocaine on bispectral index[J]. Anesth Analg, 2006, 103(6): 1464-1465.
13. 　Punjasawadwong Y, Boonjeungmonkol N, Phongchiewboon A. Bispectral index for improving anesthetic delivery and postoperative recovery[J]. Anesth Analg, 2008, 106(4): 1326.
14. 　Nordmark J, Rydqvist B. Local anaesthetics potentiate GABA-mediated Cl-currents by inhibiting GABA uptake[J]. Neuroreport, 1997, 8(2): 465-468.
15. 　Moore JM, Liu SS, Neal JM. Premedication with fentanyl and midazolam decreases the reliability of intravenous lidocaine test dose[J]. Anesth Analg, 1998, 86(5): 1015-1017.

West China Medical Journal

Effects of Intravenous Lidocaine on Propofol Anesthesia for Painless Gastroscopy

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