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国际临床研究杂志

International Journal of Clinical Research

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International Journal of Clinical Research. 2023; 7: (8) ; 10.12208/j.ijcr.20231288 .

Effects of different doses lidocaine on gerontal patients’ stress response during Postoperative recovery
不同剂量利多卡因对老年患者术后复苏期应激反应的影响

作者： 黄仕英1, 杨凤鸣2, 王嫒2, 黎燕玲2, 黄慧3,4 *, 邓军5 *

1 右江民族医学院附属医院百东分院麻醉科 广西百色

2 右江民族医学院研究生学院 广西百色

3 百色市人民医院新生儿科 广西百色

4 右江民族医学院附属西南医院新生儿科 广西百色

5 右江民族医学院附属医院毕业后教育管理科 广西百色

*通讯作者： 黄慧,单位： 右江民族医学院附属西南医院新生儿科 广西百色；邓军,单位： 右江民族医学院附属医院毕业后教育管理科 广西百色；

引用本文: 黄仕英, 杨凤鸣, 王嫒, 黎燕玲, 黄慧, 邓军 不同剂量利多卡因对老年患者术后复苏期应激反应的影响[J]. 国际临床研究杂志, 2023; 7: (8) : 10-15.
Published: 2023/8/20 17:50:45

摘要

目的 研究不同剂量利多卡因对老年患者术后复苏期应激反应的影响。方法 100例气管插管全麻老年患者随机分4组。相同麻醉药进行全凭静脉麻醉，术后送回复苏室复苏。血气分析和肌松拮抗后，4组患者分别静脉给予3种不同首负荷剂量以及3种不同维持速率利多卡因和等剂量或等速率生理盐水至拔管。记录给利多卡因前、自主呼吸恢复时、拔管前吸痰时、拔管后3分钟收缩压（SBP）、舒张压（DBP）、心率（HR）、去甲肾上腺素（NE）、血管紧张素-Ⅱ（ANG-Ⅱ）、醛固酮（ALD）以及皮质醇（COR）。结果 ①NE、ANG-Ⅱ、ALD以及COR组间比较，F值分别是13.18、25.87、18.39和54.43（p＜0.05），差异有统计学意义；大剂量组（LDG）与其余3组比较p＜0.05。②HR和SBP组间比较，F值分别是47.36和62.57（p＜0.05），差异有统计学意义，LDG与其余3组比较p＜0.05；DBP组间比较，F值3.47（p＜0.05），差异有统计学意义，LDG与小剂量组、空白剂量组比较p＜0.05，LDG与中剂量组比较p>0.05。结论 利多卡因通过剂量依赖性抑制术后复苏期气管导管刺激、拔管、吸痰、术后急性疼痛等所诱发的应激反应维持术后复苏期血流动力学平稳。

关键词： 利多卡因；老年患者；术后复苏期；应激反应；血流动力学

Abstract

Objective To study the effect of different doses lidocaine on gerontal pati-ents’ stress response during anesthesia recovery.
Methods 100 elderly patients with endotracheal intubation and general anesthesia were randomly divided into 4 groups. All the 4 groups patients were used to the same anesthetics for total intravenous anesthesia and sent back the post anesthesia care unit to recover. After blood gas analyzed and antagonized muscle relaxation，all patients in other 3 groups exclusion the blank dose group (BDG)were respectively venous infused by lidocaine with different first load doses and different maintenance velocity until extubation. Normal saline at the same first load doses and maintenance velocity until extubation as lidocaine as above mentioned was infused in the blank dose group. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate(HR), norepinephrine (NE), angiotensin-Ⅱ (ANG-Ⅱ), aldosterone (ALD) and cortisol (COR) were respectively recorded during before lidocaine administration (T0), when spontaneous breathing recovery (T1), when aspiration sputum before extubation (T2) and 3 minutes after extubation (T3).
Results ①Between-groups comparison, the F values of NE, ANG-Ⅱ, ALD and COR were 13.18, 25.87, 18.39 and 54.43 (p<0.05), respectively. With inter- groups multiple comparison there was respective significant difference among large doses group (LDG) and other three groups, ②The Between groups comparison F value of HR and SBP were 47.36 and 62.57 (p<0.05), respectively. There was significant difference among the large doses group (LDG) and other three groups. With comparison between-groups in DBP, its F value 3.47 (p<0.05).With between groups multiple compared, there was significance among LDG, the small dose group (SDG) and the blank dose groups (BDG), however there was no significance between in LDG and the middle dose group (MDG).
Conclusion   Lidocaine could maintained hemodynamic stability during postoperative recovery by dose-dependent inhibiting stress response that was stimulated to be induced by tracheal catheter stimulation, extubation, sputum of aspiration and postoperative acute pain in postoperative recovery period.

Key words： Lidocaine; Gerontal patients; During recovery; Stress response; Hemodynamics

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