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.
目的 比较预注射利多卡因和局部加温缓解罗库溴铵注射痛效果。 方法 选取2011年3月－8月择期行腹腔镜下胆囊切除术的150例患者，按照完全随机的方法分为利多卡因组（L组）、局部加温组（W组）、对照组（C组）,每组各50例患者。W组患者在留置针部位用Bair Hugger以40 °C加温1 min；L组患者用橡胶止血带在静脉近端加压直至静脉输液停止走行，推注1%利多卡因2 mL，1 min后松开止血带。随后3组患者均在2 s内静脉推注1 mL罗库溴铵注射液（含罗库溴铵10 mg）。观察在注射罗库溴铵前预先注射利多卡因及局部加温缓解注射痛的效果。 结果 罗库溴铵注射痛的发生率在W组、L组、C组中分别为62%、34%、82%。C组的疼痛发生率最高（P＜0.05）；W组的疼痛率高于L组（P＜0.05）；与W、L组相比，C组的重度疼痛率最高（P＜0.05）；L组的中、重度疼痛率低于W组（P＜0.05）。 结论 预注射利多卡因和局部加温均能有效缓解罗库溴铵引起的注射痛，预注射利多卡因对于缓解罗库溴铵引起的注射痛更为有效。
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。
ObjectivesTo systematically review the efficacy of lidocaine injected prior to tracheal extubation in preventing hemodynamic responses to tracheal extubation in general anesthesia.MethodsPubMed, Ovid, Web of Science, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of lidocaine administrated prior to extubation in preventing hemodynamic responses to tracheal extubation in patients undergoing general anesthesia from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 13.0 software.ResultsA total of 10 RCTs involving 525 patients were included. The results of meta-analysis showed that: compared with control group, lidocaine could reduce mean arterial pressure in 5 min after extubation (MD=–5.10, 95%CI –9.41 to –0.79, P=0.02), weaken the increase in systolic blood pressure caused by extubation from the moment before extubation to 5 minutes after extubation (before extubation: MD=–7.22, 95%CI –10.34 to –4.11, P<0.000 01; at extubation: MD=–14.02, 95%CI –19.42 to –8.62, P<0.000 01; 1 minutes after extubation: MD=–15.82, 95%CI –22.20 to –9.45, P<0.000 01; 3 minutes after extubation: MD=–12.55, 95%CI –20.36 to –4.74, P=0.002; and 5 minutes after extubation: MD=–12.05, 95%CI –20.35 to –3.74, P=0.004), and weakened extubation-induced increase in diastolic blood pressure at extubation (MD=–9.71, 95%CI –16.57 to –2.86, P=0.005). In addition, lidocaine inhibited heart rate in all time points except the moment of before and at 10 minutes after extubation.ConclusionsCurrent evidence shows that lidocaine can inhibit the increase in blood pressure and heart rate caused by extubation at certain times. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.
【摘要】 目的 比较利多卡因不同剂量预处理对罗库溴铵注射痛的影响。 方法 120例行全身麻醉择期手术的患者按照完全随机的方法分为利多卡因10 mg 3 mL预处理组（A组），利多卡因25 mg 3 mL预处理组（B组），利多卡因50 mg 3 mL预处理组（C组），生理盐水3 mL预处理组（D组）。观察不同剂量的利多卡因预处理对罗库溴铵注射痛的影响。 结果 A、B、C和D组注射罗库溴铵的疼痛发生率分别为53%、27%、3%和90%。与生理盐水预处理组相比，利多卡因预处理组能明显减轻罗库溴铵引起的注射痛（Plt;0.01）；剂量越大，效果越明显。 结论 利多卡因10、25、50 mg预处理均能显著降低罗库溴铵注射时引起的疼痛，以50 mg利多卡因更为有效。【Abstract】 Objective To compare the effects of different doses of lidocaine pretreatment on the pain from injection with rocuronium. Methods One hundred and twenty patients of general anesthesia had undergone elective surgery, were randomly divided into lidocaine 10 mg 3 mL pretreated group (group A), lidocaine 25 mg 3 mL pretreated group (group B), lidocaine 50 mg 3 mL pretreated group (group C) and saline 3 mL pretreated group (group D). The effects of different doses of lidocaine pretreatment on injection pain of rocuronium were observed. Results The pain incidence from injection with rocuronium in A, B, C, D groups were 53%, 27%, 3% and 90% respectively. The higher dose of lidocaine, the more obvious effect. Conclusion Lidocaine pretreatment with 10, 25, 50 mg can reduce the severity of pain from injection with rocuronium, and lidocaine 50 mg is the most effective.
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.
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.
目的 研究利多卡因对海马的神经毒性是否会对大鼠空间学习记忆能力产生影响，并探讨大鼠空间学习能力的变化与海马CA3区锥体细胞数目的相关性。 方法 将成年Wistar雄性大鼠随机分为基础值组（n=7）和利多卡因惊厥组（n=40）。基础值组大鼠静脉给予生理盐水后使用Y迷宫测定大鼠的空间学习能力。利多卡因惊厥组大鼠尾静脉持续输注利多卡因造成惊厥，待大鼠恢复正常运动以后放入鼠笼重新饲养。并于惊厥后第1、3、5、7天从中随机抓取大鼠测试其空间学习能力以及组织学改变。根据对应天数将利多卡因惊厥组的40只大鼠随机细分为Day-1、Day-3、Day-5、Day-7亚组，每亚组10只。所有大鼠在测定空间学习能力之后立即处死，取出大脑并做石蜡包埋，冠状面切片后进行组织学检测，显微镜下评估海马CA3区锥体细胞状态。 结果 ① 基础值组和Day-1、Day-3、Day-5、Day-7亚组大鼠的Y迷宫穿梭次数分别为（25.2 ± 3.7）、（27.1 ± 8.1）、（36.9 ± 9.9）、（38.7 ± 10.6）、（40.6 ± 16.3）次，除Day-1亚组与基础值组比较差异无统计学意义（P＞0.05）外，其余各亚组与基础值组差异均有统计学意义（P＜0.05）；② 与基础值组单位面积（10.3 ± 4.5）个（异常锥体）细胞比较，利多卡因惊厥组大鼠海马CA3区异常锥体细胞数增加，Day-1、Day-3、Day-5、Day-7亚组计数值分别为13.0 ± 7.2、15.6 ± 5.0、19.6 ± 8.1、18.1 ± 5.1，且与大鼠Y迷宫穿梭次数呈正相关（r=0.711，P＜0.05）。 结论 利多卡因引起的惊厥使成年大鼠海马依赖性空间学习能力下降，利多卡因的神经毒性引起的海马异常锥体细胞增多可能是造成这一现象的一种原因。