The Clinical Application Of Use Small-Dose Lidocaine Continuous Intravenous Infusion In Intraoperation

Objective:To Explore the influence of small-dose of lidocaine continued intravenous infusion in intraoperation on hemodynamic during the operation and ache and bowel function recovered after application of propofol and remifentanil.Methods:Choose40patients undergoing colon and rectum cancer surgery, the time during2011on April19to2011on August29in the First Affiliated Hospital of Guangxi Medical University.The male22cases and female18cases,age31-65years old, weight40-79kg,the body mass index18<(BMI)<30;ASA classification Ⅰ～Ⅱ,Blood pressure is normal or the levels of high blood pressure classification1-2,the Level of cardiac function classification l-2,the function of liver and kidney and the preoperative other examinations are normal, No endocrine diseases, no nervous system disease,no bradycardia and no alcoholic addiction and drug abuse,No allergic disease about lidocaine and Anesthetic drugs and no bradycardi. If when we found the toxicity reaction about lidocaine,the test must stop and deal with the intoxication.Randomly divided into lidocaine+Propofol compound Remifentanil group (L group, n=20) and Propofol compound Remifentanil group (R group, n=20).Two groups of induction and maintenance with Propofol+Remifentanil+Cisatracurium besylate.But L group infusion lidocaine1.5mg/kg before cut the skin about10minutes, late,immediate infusion small dose lidocaine1.5mg/kg/h, untill the operation over. the patients MBP and HR were recorded in the time point below, i.g. in ward (T0),in the operating room (T1),in five minutes before cut skin (T2),in Cut skin (T3),in abdominal cavity exploration (T4),in the end of the surgery (T5),in the patient awake (T6),in drawing tube (T7) and after drawing tube20minutes (T8).Record anesthesia,the operation, awake and drawing tube time.Record calm and restless scores five minutes before drawing tube and five minutes after drawing tube.Record pain scores after drawing tube5minutes and postoperative1,4,8,24,48hours with Verbal rating scale(VRS).Record total dose of Propofol and Remifentanil and the analgesic drugs in PACU and ward.Record the anus exhaust time and discharge from hospital time.Record the number of aminotransferase and creatinine bout Preoperative and postoperative48hours.Results:(1) Two groups of patients gender, age, weight and other disease have no significant difference (P>0.05).(2) L group after abdominal cavity exploration have1case used Urapidil and R group have3cases, two groups have no significant difference (P>0.05).(3)The MBP changes have a great significant difference in group dates comparison about repeated measuers at different time points (p<0.05). The MBP changes have a great significant difference between groups dates comparison (p<0.05).(4) The HR changes have a great significant difference in group dates comparison about repeated measuers at different time points (p<0.05). But the HR changes have no significant difference between groups dates comparison (P>0.05).(5)The time of anesthesia and operation and awake and withdrawal had no significant difference (P>0.05).(6) L group calm and restless scores lower than R group after drawing tube5minutes(p<0.05).It was no significant difference in group dates of L comparison (P>0.05).But R group had significant difference (p<0.05).(7) The ratio of L group, which is the dose of propofol VS the duration of anesthesia applied, is smaller than that in R group (p<0.05).But the dose of propofol and remifentanil and remifentanil VS the duration of anesthesia applied had no significant difference (P>0.05).(8) L group in the ward use analgesics lesser than R group,(P<0.05).But in PACU had no significant difference (P>0.05).(9) L group patients anal exhaust time earlier than R group (P<0.05).But the time of in ward postoperation had significant difference (P>0.05).(10) The pain scores was no significant difference between groups dates comparison (P>0.05).The pain scores had significant difference in group dates comparison (P<0.05).Conclusion:Small-dose lidocaine continuous infusion and Propofol compound Remifentanil anesthesia made the dynamics of blood flow smoothly and can reduce postoperative patients moving restlessly after undergoing colon and rectum cancer surgery and reduce the dose of Propofol and reduce postoperative analgesia drug dosage, and benefit to the recovery of the bowel function.