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.
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.
ObjectiveTo explore the effect of lidocaine on postoperative pain management after throat surgery.
MethodsSixty patients undergoing throat surgery between June 2011 and May 2013 were randomly divided into trial group and control group, with 30 in each group. Patients in the trial group accepted lidocaine for pain management, while the control group used dicaine. Pain management effect was observed and compared between the two groups.
ResultsThe pain scores of patients at hour 0.5, 2.0, 6.0, and 24.0 after surgery were 2.7±0.8, 2.2±0.9, 1.7±0.8, and 1.5±0.3 in the trial group, and 4.7±1.1, 4.2±0.8, 3.4±0.7, and 2.9±0.5 in the control group, and the differences were significant (P<0.05). Postoperative incidences 6.7% in the trial group, and 30.0% in the control group, and the difference was also significant (P<0.05).
ConclusionLidocaine can reduce the pain of patients in postoperative pain management after throat surgery, with such advantages as long-time functioning, no toxic side effect, and obvious effect, which is worth promoting.
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.
ObjectivesTo systematically review the efficacy of dyclonine and lidocaine for preparation before gastroscopy.MethodsPubMed, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) of dyclonine vs. lidocaine for preparation before gastroscopy from inception to December 31st, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 11 RCTs were included. The results of meta-analysis showed that: dyclonine could improve anesthetic effect (RR=1.38, 95%CI 1.31 to 1.47, P<0.000 01), and was more capable to remove bubble (RR=1.40, 95%CI 1.28 to 1.52,P<0.000 01), and had superior textures (RR=1.43, 95%CI 1.18 to 1.74,P=0.000 3).ConclusionsOral dyclonine can improve the visual definition of gastric mucosa and anesthetic effect, and has superior textures. Thus, dyclonine can be regarded as a recommended option prior to gastroscopy. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
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.
ObjectiveTo evaluate the clinical effects of nebulized lidocaine anesthesia and anesthesia with lidocaine and midazolam in patients with preoperative bronchoscopy.
MethodsTotally, 136 inpatients between May 2002 and June 2013 with preoperative bronchoscopy were included in the study. The patients were randomly assigned to experimental group and control group with 68 patients in each. For patients in the experimental group, 8 mL of 2% lidocaine was administered through inhalation anesthesia, followed by 2-3 mg bolus of midazolam, and subsequently 0.5 mg of midazolam was administered every 2 minutes depending on patients' awareness. Patients in the control group accepted lidocaine alone for anesthesia. The clinical efficacy and adverse effects of both the two ways of anesthesia were observed.
ResultsThe time of sustained and effective anesthesia was (24.5±2.8) minutes in the experimental group, as compared with (16.8±2.1) minutes in the control group (P<0.01). The average amount of consumption of lidocaine was (12.4±1.3) mL in the experimental group, as compared with (16.8±1.5) mL in the control group (P<0.01). The heart rate at 5 min after operation was (81.5±19.5) beats/min in the experimental group, as compared with (94.6±34.6) beats/min in the control group (P<0.01). The mean pulse oxygen saturation at 5 min after operation was (93.5±3.6)% in the experimental group, as compared with (88.2±13.3)% in the control group (P<0.01).
ConclusionCombined application of lidocaine and midazolam before bronchoscopy is simple and feasible for anesthesia, which has higher success rate, lesser side effects and other reactions such as body movement and coughing.
ObjectiveTo study the feasibility of using propofol and remifentanil for tracheal intubation in patients who are awake, and investigate the influence of tracheal intubation on such vital signs as blood pressure and heart rates.
MethodsEighty ASA I-Ⅱ patients who underwent general anesthesia in our hospital between December 2012 and April 2013 were randomly divided into two groups. Patients in group A received fentanyl-propofol, while patients in group B received remifentanyl-propofol-lidocaine. There was no significant difference between the two groups in gender, age, and body weight (P>0.05). Conventional intubation induction method was used for group A:0.05-0.10 mg/kg midazolam, 4 μg/kg fentanyl, 1.0-1.5 mg/kg propofol, and 0.6-0.9 mg/kg atracurium were given and tracheal intubation was performed after muscle relaxation. Group B patients were treated with remifentanyl propofol-lidocaine compound liquid slow intravenous injection, and compound cricothyroid membrane puncture method before endotracheal intubation. We observed the two groups of patients for vital signs before and after induction, and choking cough reactions.
ResultsPatients in both the two groups were all able to complete tracheal intubation. Circulation change and incidence of tachycardia in patients of group A were significantly higher than those in group B (P<0.05). The rates of bradycardia, hypoxemia, and choking cough response were low in both groups with no statistically significant difference (P>0.05).
ConclusionRemifentanyl propofol-lidocaine compound liquid can be safely used for implementation of endotracheal intubation in patients who are awake, and the hemodynamic stability can be maintained.
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.
ObjectiveTo systematically review the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion.
MethodsWe searched PubMed, EMbase, The Cochrane Library, WanFang Data, VIP, CBM and CNKI databases concerning randomized controlled trial (RCT) of the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion from their inception to January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software.
ResultsSix RCTs involving 384 patients were included. The results of meta-analysis showed that there were no significant differences between the lidocaine group and the saline group in pain and discomfort scores (MD=-25.35, 95%CI -30.37 to -24.33) and first successful insertion rate (RR=1.38, 95%CI 1.21 to 1.57).
ConclusionIntranasal lidocaine spray before nasogastric tube insertion could reduce patient pain and discomforts related to the procedure, and improve the first successful insertion rate.
