利多卡因和丙泊酚复合静脉麻醉在腹腔镜子宫切除术中的应用

目的通过综合评估不同剂量的丙泊酚和利多卡因复合应用于腹腔镜子宫切除术麻醉的可行性，并摸索适合的临床用药剂量。方法将60例择期行腹腔镜子宫切除手术患者，随机分为3组，给予不同剂量的丙泊酚和利多卡因维持麻醉。连续监测脑电双频指数（BIS），血流动力学参数，苏醒情况。结果各组患者诱导后BIS值均明显降低，Ⅱ、Ⅲ组术中患者BIS值明显低于Ⅰ组。血液动力学参数变化Ⅰ组他时点心率（HR）低于阳时点，差异有统计学意义（P〈0．05）Ⅰ，Ⅱ，Ⅲ组T1、T2、T3、T4、T5、T6时点无刨平均动脉压（MAP）低于T0（P均〈0．05）。组间比较：Ⅱ组T2、T4时点MAP分别低于Ⅰ组相应时点，差异有统计学意义（P均〈0．05）。Ⅲ组患者自主呼吸恢复时间和唤之睁眼时间与Ⅰ、Ⅱ组相比明显增加，差异有统计学意义（P〈0．05）。Ⅰ组中有1例发生术中知晓，而Ⅲ、Ⅱ组无此情况。各组拔管时间、定向力恢复时间比较差异无统计学意义。结论丙泊酚和利多卡因复合静脉麻醉在腹腔镜子宫切除手术中应用具有可行性，推荐剂量为利多卡因1mg／（kg·h）加丙泊酚3mg／（kg·h）。

Application of intravenous anesthesia combined with lidocaine and propofol in laparoscopic hysterectomy

Objective To assess different doses of propofol and lidocaine compound for a multi - disciplinary approach used in laparoscopic hysterectomy anesthesia, and search for the quantity of clinical trial dosage. Methods Sixty patients undergoing laparoscopic hysterectomy patients were randomly divided into 3 groups, given different doses of propofol and lidocaine to maintain anesthesia and continuous monitoring Bispectral Index （BIS）, hemodynamic parameters, condition of recovery time. Results BIS values of patients in each group after the induction were significantly lower, groups Ⅱ , Ⅲ were significantly lower than that of group Ⅰ . Comparing within groups, group Ⅰ HR in TO was lower than HR in T2, the difference was significant （ P 〈 0. 05） ; MAP of group Ⅰ , Ⅱ , Ⅲ in T1, T2, T3, T4, T5, T6 time point was lower than MAP in TO （ P 〈 0.05）. MAP of group Ⅱ at T2, T4 was lower than that of group I in corresponding time point respectively, there was significant difference （ P all 〈 0.05）. Resumption of breathing on his own time and call time and the eyes open of patients in group Ⅲ increased significatly than group in Ⅰ and Ⅱ , the difference was statistically significant （ P 〈 0.05）. Group Ⅰ had one case of knowing during operation. Extubation time of each group and the restoration of orientation time had no significant difference. Conclusion Intravenous anesthesia combined Propofol with lidocaine is feasible in the application of laparoscopic hysterectomy, the recommended dose is lidocaine 1 mg/（ kg· h） and propofol 3 mg/ （kg·h）.