[1]汪 舸,王胜斌,居 霞,等.利多卡因复合右美托咪定对胃癌根治联合术中腹腔热灌注化疗患者的影响[J].医学信息,2021,34(10):83-87，82.[doi:10.3969/j.issn.1006-1959.2021.10.023]
　WANG Ge,WANG Sheng-bin,JU Xia,et al.The Effect of Lidocaine Combined with Dexmedetomidine on Patients with Radical Gastric Cancer Combined with Hyperthermic Intraperitoneal Chemotherapy[J].Medical Information,2021,34(10):83-87，82.[doi:10.3969/j.issn.1006-1959.2021.10.023]
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利多卡因复合右美托咪定对胃癌根治联合术中腹腔热灌注化疗患者的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年10期
页码:
83-87，82
栏目:
论著
出版日期:
2021-05-15

文章信息/Info

Title:
The Effect of Lidocaine Combined with Dexmedetomidine on Patients with Radical Gastric Cancer Combined with Hyperthermic Intraperitoneal Chemotherapy
文章编号:
1006-1959（2021）10-0083-05
作者:
汪 舸; 王胜斌; 居 霞; 等
（安徽医科大学附属安庆医院麻醉科，安徽 安庆 246003）
Author(s):
WANG Ge; WANG Sheng-bin; JU Xia; et al.
(Department of Anesthesiology,Anqing Hospital Affiliated to Anhui Medical University,Anqing 246003,Anhui,China)
关键词:
利多卡因; 右美托咪定; 肠道功能; 胃癌根治术; 腹腔热灌注化疗
Keywords:
Lidocaine; Dexmedetomidine; Intestinal function; Radical gastric cancer; Hyperthermic intraperitoneal chemotherapy
分类号:
R735.2
DOI:
10.3969/j.issn.1006-1959.2021.10.023
文献标志码:
A
摘要:
目的 探讨利多卡因复合右美托咪定静脉输注对胃癌根治术联合术中腹腔热灌注患者术后肠道功能恢复的影响。方法 选择2019年4月~2020年7月于我院肿瘤外科住院，并行择期全胃根治性切除术联合术中腹腔热灌注化疗（HIPEC）的患者80例，随机分为利多卡因组（L组）、右美托咪定组（D组）、利多卡因复合右美托咪定组（LD组）以及对照组（C组），每组20例；麻醉诱导前10 min分别注射负荷量的利多卡因、右美托咪定、利多卡因复合右美托咪定和等容量生理盐水，持续泵注维持剂量至灌注开始后15 min。比较①术前6h、术后6h的血清D-乳酸含量；②患者麻醉时间、手术时间、恢复时间、拔管时间、瑞芬太尼剂量、PCIA按压次数、首次肠道通气时间、排便时间和住院时间；③术后6、12、18、24及48 h视觉模拟量表（VAS）评分；④拔管后1、5、15、30 min Ramsay镇静评分（RSS）评分。结果 四组术后6 h的血清D-乳酸含量较术前6 h均有升高（P＜0.05)；L组、LD组患者术后6 h血清D-乳酸含量低于C组，且LD组术后6 h的血清D-乳酸含量最低（P＜0.05)；L组、LD组术后首次排气时间和排便时间短于C组（P＜0.05)，LD组住院时间亦缩短；与C组、D组和L组比较，LD组术后48 h 内VAS评分降低，拔管后20 min内RSS评分升高（P＜0.05)；D组与LD组静脉自控镇痛泵按压次数少于C组，L组、D组和LD组丙泊酚和瑞芬太尼用量少于C组（P＜0.05）。结论 利多卡因复合右美托咪定静脉输注可以促进胃癌根治术联合术中腹腔热灌注化疗患者术后肠道功能的恢复，并增加患者术后舒适度和术后镇痛效果，缩短患者住院时间。
Abstract:
Objective To investigate the effect of intravenous infusion of lidocaine combined with dexmedetomidine on the recovery of intestinal function in patients with radical gastric cancer combined with hyperthermic intraperitoneal chemotherapy of the abdominal cavity.Methods A total of 80 patients who were hospitalized in the Oncology Surgery of our hospital from April 2019 to July 2020 were selected for elective radical gastrectomy combined with Hyperthermic Intraperitoneal Chemotherapy(HIPEC).Randomly divided into lidocaine group (L group), dexmedetomidine group (D group), lidocaine combined with dexmedetomidine group (LD group) and control group (C group), 20 cases in each group;10 min before induction of anesthesia, a loading dose of lidocaine, dexmedetomidine, lidocaine combined with dexmedetomidine and equal volume of normal saline were injected respectively, and the maintenance dose was pumped continuously until 15 min after the start of infusion.Comparing ①The serum D-lactic acid content at 6h before operation and 6h after operation;②The patient’s anesthesia time, operation time, recovery time, extubation time, remifentanil dosage, PCIA compression times, first intestinal ventilation time, defecation time and hospital stay;③ Visual analog scale (VAS) score at 6, 12, 18, 24 and 48 h after surgery;④Ramsay sedation score (RSS) score at 1, 5, 15, and 30 min after extubation.Results The levels of serum D-lactic acid in the four groups at 6 h after operation were higher than those at 6 h before operation (P＜0.05);The serum D-lactic acid content of the patients in the L group and the LD group was lower than that of the C group at 6 h after the operation, and the serum D-lactic acid content in the LD group was the lowest at 6 h after the operation (P＜0.05);The first exhaust time and defecation time after operation in the L group and LD group were shorter than those in the C group (P＜0.05),The length of stay in the LD group was also shortened; compared with the C, D and L groups, the VAS score in the LD group decreased within 48 h after the operation, and the RSS score increased within 20 min after extubation (P＜0.05);The number of times of intravenous patient-controlled analgesia pump compression in group D and LD was less than that in group C, and the dosage of propofol and remifentanil in group L, D and LD was less than that in group C (P＜0.05).Conclusion Lidocaine combined with intravenous infusion of dexmedetomidine can promote the recovery of intestinal function in patients with radical gastric cancer combined with hyperthermic intraperitoneal chemotherapy, increase the postoperative comfort and postoperative analgesia, and shorten the patient Length of hospital stay.

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更新日期/Last Update: 1900-01-01