Objective To systematically review the effects of lidocaine for preventing pain on injection of propofol. Methods Databases including The Cochrane Library (Issue 4, 2012), PubMed, MEDLINE, Ovid, HighWire, EMbase, CBM and CNKI were searched electronically to collect literature published from January, 1985 to December, 2012. Randomized controlled trials (RCTs) were indentified about lidocaine for preventing injection pain of propofol. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assess the quality of the included studies. Then meta-analysis was performed using RevMan 5.1 software. Results Fifteen trials involved 1 332 patients were included. The results of meta-analysis indicated that, adding lidocaine into propofol lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.36, 95%CI 0.30 to 0.44, Plt;0.000 01); using different doses of lidocaine before injection lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.59, 95%CI 0.47 to 0.75, Plt;0.000 1); using different doses of lidocaine after venous occlusion lowered the incidence of pain on injection compared with blank control, with a significant difference (RR=0.44, 95%CI 0.37 to 0.52, Plt;0.000 01). Conclusion Lidocaine could reduce the pain on injection of propofol. Using lidocaine 40 mg after venous occlusion is a relatively effective method to lower the incidence of pain on injection which is more suitable for outpatient who receive intravenous anesthesia without preoperation medication.
目的:比较芬太尼与利多卡因宫旁阻滞麻醉在人工流产术中的疗效。方法:选择我院2009年3月~2009年5月门诊终止妊娠早孕妇女100例,分为两组。芬太尼组50例,利多卡因组50例。比较两组宫旁阻滞麻醉镇痛效果及人流综合征发生率。结果:芬太尼组的镇痛效果明显优于利多卡因组,人流综合征的发生率明显低于利多卡因组。结论:芬太尼宫旁阻滞麻醉具有镇痛效果明显，人流综合征发生率低等优点，优于利多卡因麻醉效果。
目的:比较复方利多卡因和盐酸利多卡因的麻醉效果。方法:将 200 例口腔局麻的患者随机分为试验组和对照组,试验组应用复方利多卡因,对照组应用盐酸利多卡因。结果: 复方利多卡因的麻醉效果及时间明显优于盐酸利多卡因,两者结果在统计学上有显著性差异(Plt;0 01)。结论: 复方利多卡因具有显效时间快、作用时间长、止痛效果好的特点,特别是口腔科术后长效镇痛效果明显,值得推广应用。
目的：观察利多卡因宫旁阻滞联合宫腔灌注在人流术中镇痛的效果。方法:收集我院2005年1～2月门诊终止妊娠的早孕妇女共94例并分为两组:单纯宫旁阻滞组（简称单纯组）35例，宫旁阻滞联合宫腔灌注（简称联合组）59例。比较两种利多卡因局麻方式的效果。结果:（1)两组的止痛效果无明显差异(P=0.893);(2)联合组对宫颈的松弛作用优于宫旁阻滞(Ｐ=0.000);(3)联合组较多病例出现眩晕、耳鸣等副反应。结论:与单纯宫旁阻滞相比，宫旁阻滞联合宫腔灌注并无明显优势。
Injury of dorsal root ganglia (DRG) may cause sensory and motor dysfunction. In order to investigate the changes of somato-sensory evoked potential (SEP) and histological characteristics of DRG in different causes and different periods of injury, fifty-two rabbits were chosed to build the models. The rabbits were divided into 4 groups: Control group (n = 4); mechanical compressing group (n = 16); inflammatory injury group (n = 16); and treatment group (2% lidocaine with hydroprednisone was administered locally, n = 16). After one to eight weeks, SEP was determined and samples of DRG were obtained to observe the histological and ultrastructural changes every week. The result showed that the gap junction of microvascular endothelium in DRG had been destroyed by the mechanical compression was the major cause of the vessel permeability increasing. The increasing of endothelial pinocytic vesicles transportation and widening of endothelial gap junction were the main causes of inflammatory irritation of DRG. The local infiltration with 2% lidocaine and hydroprednisone could obviously ameliorate inflammatory injury in DRG.
Objective To investigate the effectiveness of pretreatment with mixture of lidocaine and flurbiprofen axetil in reducing injection pain of propofol. Methods One hundred and sixty ASI I–II patients undergoing general anaesthesia were randomly allocated into four groups (40 cases in each group): the control group, the lidocaine (Lc) group, the flurbiprofen axetil (FA) group and the mixture of lidocaine and flurbiprofen axetil (hereafter termed as “mixture”) group. After the occlusion of venous drainage, patients were pretreated with 7 mL of 0.9% saline in the control group, 5 mL (50 mg) of flurbiprofen axetil and 2 mL of 0.9% saline in the FA group, 2 mL (40 mg) of 2% lidocaine and 5 mL of 0.9% saline in the Lc group, and 5 mL (50 mg) of flurbiprofen axetil and 2 mL (40 mg) of 2% lidocaine in the mixture group, respectively. The occlusion was released 2 min later and then 0.5 mg/kg propofol was injected into the vein within 5 s. During injecting propofol, the patients were asked by another anesthetist to assess and record their pain through using VSR. Results No significant differences in the demographic characteristics were found among the four groups. In comparison with the control group, the incidence rates of propofol injection pain were obviously lower in the mixture group, the FA group and the Lc group (Plt;0.05); there was a significant reduction in the incidence rate of pain in the mixture group compared with the other three groups. The median pain score was significantly lower in the mixture group and the Lc group than that in the control group. During the 24 hour follow-up after operation, neither the adverse events such as red-swelling in injection site, phlebitis or drug eruption, nor the gastrointestinal stimulating signs were found. Conclusion The mixture of flurbiprofen axetil and lidocaine is found to be more effective in reducing injection pain of propofol.
Objective To assess the anesthetic efficacy of articaine versus lidocaine for irreversible pulpitis. Methods We electronically searched PubMed, EMbase, Cochrane Library (Issue 4, 2009), CNKI, VIP and CBM. The search was updated to December 2009. Randomized controlled trials (RCTs) and quasi-RCTs were indentified about articaine and lidocaine for irreversible pulpitis. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. And RevMan5.0 was applied for statistical analysis in success rate. Results Nine trials involving 985 pulpitis patients were included. Meta-analysis indicated that, both the anesthetic success rate (RR=1.33, 95%CI 1.23 to1.44) and maxillary anesthetic success rate (RR=1.65, 95%CI 1.38 to 1.98) of articaine were superior to that of lidocaine, but there was no statistical significance in mandibular anesthetic success rate between two groups (RR=1.28, 95%CI 0.97 to 1.69). Conclusion The current evidence shows that articaine is superior to lidocaine in anesthetic efficacy, and is good at maxillary anesthesia.
Objective To evaluate the analgesic effect of intra-articular ropivacaine with lidocaine. Methods A double-blind randomized controlled trial was conducted. Ninety patients receiving selective knee arthroscopy were randomized into three groups of 30 patients. At the end of the operation, before the release of the tourniquet, an intra-articular injection was administered to each patient through arthroscope, in accordance with their random allocation: 0.9% normal saline (normal saline group); 100 mg ropivacaine (ropivacaine alone group) and 100 mg ropivacaine and 100 mg 2% lidocaine (ropivacaine with lidocaine group). Pain intensity was assessed after the operation using the 100-mm visual-analog scale (VAS), and the amount of supplemental analgesics used within the following 24 hours were recorded. Results The VAS scores of 2 hours postoperatively at rest, and 1, 2, 4, and 8 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine alone group (Plt;0.05). The VAS scores 0.5, 1 and 2 hours postoperatively at rest, and at the awaking moment, 0.5, 1, 4, 8, and 24 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine with lidocaine group (Plt;0.05). Conclusion Intra-articular ropivacaine can reduce a patient’s pain after operation. The combination of lidocaine with intra-articular ropivacaine can reduce the patient’s pain severity immediately after the operation and achieve an early analgesic effect.
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。