The Effects Of Lidocaine Infused During Perioperative On Stress Response In Patients Undergoing Laparoscopic Hysterectomy

Objective:To evaluate the effects of lidocaine infused during perioperative of laparoscopic hysterectomy on hemodynamics, levels of plasma cortisone and blood sugar(BS), to observe the influence of postoperative VAS of pain, of abdominal comfort and Post Operative Nausea And Vomitting (PONV) of patients. Provides the theory basis for perioperative stress response intervention of Laparoscopic hysterectomy patients.Methods:Forty patients diagnosed hysteromyoma, ASA physical status I or II, undergoing elective laparoscopic hysterectomy were randomly assigned into two groups with20cases each:group L(lidocaine infusion); group P(the control group). All the cases were premeditated with sodium luminal (100mg) and atropine (0.5mg) prior to operation. Two veins of left upper extremity was opened for transfusion and administration of lidocaine. Elbow vein of right upper extremity was used for collection of blood sample.15min before induction of anesthesia,1.5mg/kg (5min) lidocaine were given in grpup L followed by2%lidocaine in1.5mg· kg-1· h-1until operation over while group P given the same volume of saline. General anesthesia was induced with midazolam0.1-0.2mg/kg, fentanyl2-4μg/kg, propofol1-1.5mg/kg and rocuronium0.6mg/kg in order in both groups.OhmedaS/5was used to control respiration after intubation. General anesthesia was maintained with inhaling sevoflurane, fentanyl and atracurium. Intraoperative abdominal pressure was12mmHg. BIS was40-60, PETCO2was between35-45mmHg. ECG、HR、MAP、 SPO2、PETCO2and BIS were continuously monitored. Plasma hydrocortisone and BS were determined after opration24h,48h and72h. Follow up and record the time of first anal exhaust, the time of first defecation and the time of first leaving bed. VAS of abdominal pain when coughing and at rest, VAS of abdominal comfort and the AS PONV were recorded of all patients in two groups at awake time and after operation6h,24h and48h. All the data were analysised by SPSS11.0software.Results:(1) SBP、DBP、MAP and HR:Before anesthesia all measured value did not differ much between group L and group P (P>0.05); SBP、DBP、MAP and HR were increased after intubation compared to To in group P (P<0.01), in group L SBP、 DBP、MAP were increased at T4and HR change is not obvious, there were no significant difference at other points; BP、DBP、MAP�'�P HR at T5and T7were notably higher in group P compared to group L (P<0.01)(2) The time of first exhaust, defecation and leaving bed:the time of first exhaust and defecation in group L was notable shortened compared with group P, there was no notable difference in the time of first leaving bed between two groups.(3) BS and cortisone:Before anesthesia all measured value did not differ much between group L and group P (P>0.05); the plasma contents of BS24h after operation increased significantly in both groups, no difference at other points, the plasma contents of cortisone in group P were notable higher than group L in three points.(4) Abdominal pain VAS, abdomen comfort VAS and PONV VAS:Abdominal pain VAS and PONV VAS in group P was notably higher compared to group L,but abdomen comfort VAS in group P was significantly lower than group LConclusion:(1) Lidocaine infused during perioperative can reduce effectively stress response, but not completely.(2) Lidocaine infused during perioperative can decrease the dosages of narcotic analgesics, promote functional recovery of gastrointestinal and improve the patient, s satisfaction.