ObjectivesTo systematically review the prophylactic efficacy of lidocaine administrated intravenously in advance on rocuronium associated injection pain/withdrawal movement in patients under general anesthesia.MethodsPubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant randomized controlled trials (RCTs) on pretreatment with lidocaine intravenously to prevent injection pain /withdraw movement from rocuronium from inception to September 30th, 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 software.ResultsA total of 30 RCTs involving 2 518 patients were included. The results of meta-analysis showed that, compared to the control group, pretreating with intravenous lidocaine could significantly reduced the occurrence of total pain/withdrawal movement associated with rocuronium injection (RR=0.43, 95%CI 0.36 to 0.51, P<0.000 01), and whether with (RR=0.39, 95%CI 0.29 to 0.52, P<0.000 01) or without (RR=0.45, 95%CI 0.36 to 0.57, P<0.000 01) occluding the vein, intravenous lidocaine could prevent pain/withdrawal movement associated with rocuronium injection. In addition, the incidence of lidocaine group igniting moderate (RR=0.38, 95%CI 0.31 to 0.46, P<0.000 01) or severe (RR=0.23, 95%CI 0.18 to 0.30, P<0.000 01) pain/ withdrawal movement were less likely to occur. However, there was no difference between the lidocaine and control group in the incidence of mild injection pain/withdrawal movement induced by rocuronium (RR=0.89, 95%CI 0.75 to 1.06, P=0.19).ConclusionsCurrent evidence shows that pre-intravenous lidocaine can reduce the occurrence of injection pain/withdrawal movement associated with rocuronium injection patients, especially in the prevention of moderate and severe injection pain/withdrawal movement.
ObjectiveTo explore the clinical effect of lidocaine mucilage diluent and simethicone emulsion in gastroscopy examination, in order to provide effective drugs for gastroscopy.
MethodsWe selected 201 outpatients and the inpatients who underwent gastroscopic examination between August and October 2014 as the research subjects. Based on the kind of drug, the patients were randomly divided into research group (n=100) and control group (n=101). Patients in the research group accepted lidocaine mucilage diluent, while those in the control group received simethicone emulsion. Then we observed and compared the definition of gastroscopy, adverse drug reactions, examination time and drug price between the two groups.
ResultsThe frequencies of high, medium, and low definition of gastroscopy were respectively 63.00%, 34.00% and 3.00% among the patients in the research group, and 69.31%, 26.73% and 3.96% among patients in the control group; there was no significant differences between the two groups (Z=-0.854, P=0.393). The adverse reaction rates, testing time, and drug prices for the two groups were 0.99% vs.1.00% (P>0.05), (6.5±2.1) minutes vs.(6.6±2.0) minutes (t=0.458, P>0.05), and RMB (9.0±1.2) yuan vs.(42.8±2.8) yuan (t=227.644, P<0.05), respectively.
ConclusionLidocaine mucilage diluent and simethicone emulsion both have good effect for gastroscopic examination, which can raise the gastroscopic definition, promote endoscopic operation and observation by doctors, shorten examination time, and reduce adverse drug reactions. Both are of great value in clinical application, and lidocaine hydrochloride mucilage diluent is cheaper, which can be widely used and promoted clinically.
Objective To investigate the applied significance of adjustable low-concentration of mixed oxygenand nitrous oxide inhalation sedation combined with lidocaine local anesthesia in anorectal surgery. Methods Three hundreds patients underwent anorectal surgery in our hospital were divided into control group （n=154） and observation group （n=146）. Patients of control group underwent pure lidocaine local anesthesia， and patients of observation group underwent mixed oxygen and nitrous oxide sedation analgesia combined with lidocaine local anesthesia. Vital signs before and after operation as well as results of sedation and analgesia were compared between the 2 groups. Results Anorectal surgeries of all patients were performed successfully. There were no significant differences on change of heart rate， blood pressure， and oxygen saturation between the 2 groups before and after operation （P＞0.05）. The operation time between the control group 〔（36.3±6.8） min〕 and observation group 〔（35.4±6.5） min〕 had no statistically significant difference（t=-0.607， P=0.544）. The analgesic effects （Z=-6.859， P=0.000） and sedative effects （Z=-5.275， P=0.000） of obser-vation group were both better than those of control group. Conclusions Low-concentration of mixed oxygen and nitrous oxide inhalation sedation combined with lidocaine local anesthesia can relieve the discomfort of fear and pain， no side-impacts on vital sign before and after operation were observed，and it has better effects of sedation and analgesia， therefore it can be recommended to clinical application.
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.
【摘要】 目的 比較利多卡因不同劑量預處理對羅庫溴銨注射痛的影響。 方法 120例行全身麻醉擇期手術的患者按照完全隨機的方法分為利多卡因10 mg 3 mL預處理組（A組），利多卡因25 mg 3 mL預處理組（B組），利多卡因50 mg 3 mL預處理組（C組），生理鹽水3 mL預處理組（D組）。觀察不同劑量的利多卡因預處理對羅庫溴銨注射痛的影響。 結果 A、B、C和D組注射羅庫溴銨的疼痛發生率分別為53%、27%、3%和90%。與生理鹽水預處理組相比，利多卡因預處理組能明顯減輕羅庫溴銨引起的注射痛（Plt;0.01）；劑量越大，效果越明顯。 結論 利多卡因10、25、50 mg預處理均能顯著降低羅庫溴銨注射時引起的疼痛，以50 mg利多卡因更為有效。【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.
Lidocaine is an amide local anaesthetic. In recent years, clinical evidence shows that perioperative intravenous lidocaine injection plays an active role in anti-inflammation, analgesia, anti-tumor and organ protection. Postoperative pain is severe in patients after thoracic surgery, and the incidence of pulmonary complications and cognitive impairment is high. These adverse reactions and complications are closely related to the inflammatory reaction after thoracic surgery. Intravenous infusion of lidocaine may have some effects on alleviating these adverse reactions and complications. Thus, this article reviews the current status of intravenous lidocaine injection in thoracic surgery and explores the related mechanisms to optimize the management of anaesthesia during the perioperative period of thoracic surgery.
