摘要目的 评价腹腔镜胆囊切除术后患者静脉输注利多卡因的镇痛效果.方法 拟行腹腔镜胆囊切除术患者25例,ASA分级Ⅰ或Ⅱ级,年龄30～55岁,体重50～70 kg,麻醉前即刻静脉注射利多卡因1.5 mg/kg,静脉注射芬太尼2 μg/kg、异丙酚2 mg/kg、罗库溴铵1 mg/kg诱导气管插管,吸入1.5%～2.0%异氟烷维持麻醉,间断静脉注射罗库溴铵.手术结束时开始静脉输注利多卡因1.5 mg·kg-1·h-1至术后24 h.于术后1、6、12、24 h时采用视觉模拟评分法(VAS)评价腹痛和肩痛程度(VAS评分≤3分为镇痛有效),记录有关不良反应的发生情况.结果 术后6～24 h镇痛有效率为100%.未见有关不良反应发生.结论 利多卡因静脉给药用于腹腔镜胆囊切除术后患者镇痛的效果良好.

abstractsObjective To investigate the analgesic efficacy of intravenous administration of lidocaine in patients following laparoscopic cholecystectomy. Methods Twenty-five ASA Ⅰ or Ⅱ patients, aged 30-55 yr,weighing 50-70 kg, scheduled for laparoscopic cholecystectomy, were enrolled in this study. Lidocaine 1.5 mg/kg was injected intravenously immediately before anesthesia. Anesthesia was induced with intravenous fentanyl 2 μg/kg, propofol 2 mg/kg and rocuronium 1 mg/kg and maintained with inhalation of isoflurane (end-tidal concentration 1.5%-2.0%) and intermittent iv boluses of rocuronium after tracheal intubation. Lidocaine was infused abdominal intravenously at a rate of 1.5mg·kg-1·h-1 form the end of ofperation to 24 h after operation. The degree of abdominal pain and shoulder pain was assessed with VAS score at 1, 6, 12 and 24 h after operation. The effective analgesia was defined as VAS score of ≤ 3. The adverse reactions were recorded. Results The effective analgesia rate was 100% within 24 h after operation. No adverse reactions occurred. Conclusion Intravenous administration of lidocaine exerts satisfactory analgesia in patients after laparoscopic cholecystectomy.