静脉注射利多卡因对炎症性肠病患者结肠镜检查过程中阿芬太尼消耗量的影响：一项随机对照试验

IF 0.1 Q4 ANESTHESIOLOGY

Acta anaesthesiologica Belgica Pub Date : 2020-07-30 DOI:10.21203/rs.3.rs-50910/v1

Twan Aalbers, S. Heuvel, E. Bronkhorst, A. V. Esch, G. Scheffer, M. Vaneker

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引用次数: 0

摘要

背景:在结肠镜检查过程中使用镇静镇痛(PSA)以方便手术和减轻患者的不适。PSA的首要风险是呼吸抑制。利多卡因可能是IBD患者的一种有希望的额外镇痛药，以减少PSA的副作用。我们的主要目的是调查静脉注射利多卡因是否减少了IBD患者PSA期间阿芬太尼的用量。此外，我们还研究了利多卡因是否能减少心肺事件和手术过程中异丙酚的用量。方法:2016年11月至2018年12月，在内梅亨大学医学中心内窥镜室进行了一项随机、双盲、安慰剂对照研究。76例IBD患者，ASA 1或2，年龄在18至65岁之间，计划进行PSA结肠镜检查。患者在结肠镜检查时先接受利多卡因1.5 mg kg-1，然后连续输注2 mg kg-1 h-1(干预组，n=38)或等量0.9%生理盐水(对照组，n=38)。结果:与对照组相比，利多卡因组阿芬太尼(327µg, 95%CI=-31-505, p=0.082)和异丙酚(39 mg, 95%CI=-5-83, p=0.083)的使用均有所减少。对照组10例(26%)，利多卡因组8例(21%)出现缺氧期(p=0.788)。两组患者均未出现低血压。结论:我们的研究表明，在接受PSA结肠镜检查的患者中，异丙酚和阿芬太尼的使用有所减少。差异无统计学意义。利多卡因并没有降低心肺事件的发生率。试验注册:草案号2016-002210-46,2016年5月19日注册，https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-002210-46/resultsISRCTN; ISRCTN47787339，回顾性注册，2019年2月6日注册，http://www.isrctn.com/ISRCTN47787339

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Effects of Intravenous Lidocaine on Alfentanil Consumption During Procedural Sedation for Colonoscopy in Patients With Inflammatory Bowel Disease: a Randomized Controlled Trial

Background: Procedural sedation and analgesia (PSA) is used during colonoscopy to facilitate the procedure and relieve patient’s discomfort. The foremost risk of PSA is respiratory depression. Lidocaine could be a promising additional analgesic in IBD patients to minimise side effects of PSA.Our primary objective was to investigate whether i.v. lidocaine reduces the amount of alfentanil used during PSA in IBD patients. Additionally, we investigated whether lidocaine reduces cardiorespiratory incidents and the amount of propofol required during the procedure.Methods: A randomised, double-blind, placebo controlled study was performed at the endoscopy unit of the Radboud University Medical Centre from November 2016 to December 2018. Seventy-six patients with IBD, ASA 1 or 2, between 18 and 65 years, scheduled for colonoscopy with PSA were included. Patients received lidocaine 1.5 mg kg-1 followed by a continuous infusion of 2 mg kg-1 h-1 (intervention group, n=38) or 0.9% saline in equivalent volumes (control group, n=38) during colonoscopy.Results: There was a reduction in the use of alfentanil (327µg (95%CI=-31-505, p=0.082)), and propofol (39 mg (95%CI=-5-83, p=0.083)) in the lidocaine group compared with the control group. Ten patients (26%) in the control group and 8 patients in the lidocaine group (21%) experienced a period of hypoxia (p=0.788). In both groups, no periods of hypotension were noted.Conclusion: Our investigation has shown a reduction in the use of propofol and alfentanil in patients undergoing colonoscopy with PSA. The differences were not statistically significant. Lidocaine did not reduces the incidence of cardiorespiratory events.Trial registration:EudraCT, 2016-002210-46, registered 19 may 2016,https://www.clinicaltrialsregister.eu/ctr-search/trial/2016-002210-46/resultsISRCTN, ISRCTN47787339, retrospectively registered 6 February 2019, http://www.isrctn.com/ISRCTN47787339

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来源期刊

Acta anaesthesiologica Belgica ANESTHESIOLOGY-

CiteScore

0.20

自引率

0.00%

发文量

期刊介绍： L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an. L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux. Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, … Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.