<b><span>Background: </span></b><span>After functional endoscopic nasal surgery, emergence agitation is not uncommon. The aim of this trial was to investigate the effect of perioperative ...<b><span>Background: </span></b><span>After functional endoscopic nasal surgery, emergence agitation is not uncommon. The aim of this trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality and incidence of emergence agitation in patient undergoing functional endoscopic sinus surgery.</span><span> </span><b><span>Study Design:</span></b><b><span> </span></b><span>Prospective, randomized, double-blinded, placebo-controlled trial.</span><span> </span><b><span>Methods: </span></b><span>100 patients of ASA I and II, aged 18</span><span> </span><span>-</span><span> </span><span>50 years, of both sexes scheduled for FEES, were assigned into two groups. In Group L;patients received an intravenous bolus infusion of 1.5</span><span> </span><span>mg/kg lidocaine just before induction of anesthesia followed by a continuous infusion of 2</span><span> </span><span>mg/kg/h during the operation and until the end of the surgery. In Group C;patients received normal saline infusion with the same volume as group L according to the same protocol. The primary endpoints were incidence of emergence agitation and postoperative recovery quality (QoR-40) score on first postoperative day (POD1).</span><span> </span><b><span>Results:</span></b><b><span> </span></b><span>Incidence of emergence agitation was significantly lower in group L (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) compared with group C. Global QoR-40 scores on POD1 w</span><span>ere</span><span> significantly lower in both groups compared with preoperative assessment, it was significantly higher in group L on POD1 (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) than in group C. Among the five dimensions of QoR-40, the scores for physical comfort and pain were superior in group L compared to group C (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) at POD1.</span><span> </span><b><span>Conclusion: </span></b><span>Systemic lidocaine infusion can improve </span><span>QoR-40 scores and decrease incidence of emergence agitation in patients scheduled</span><span> for FEES</span><span>,</span><span> also it reduce</span><span>s</span><span> the duration of stay in PACU after surgery.</span>展开更多
目的观察超体重(孕前体质量指数≥25kg/m^(2))产妇剖宫产术中应用超声引导下椎管内麻醉联合腹横肌平面神经阻滞的效果,探讨其在术后康复中的作用。方法行剖宫产手术超体重产妇240例,随机分为观察组和对照组各120例。对照组椎管内麻醉采...目的观察超体重(孕前体质量指数≥25kg/m^(2))产妇剖宫产术中应用超声引导下椎管内麻醉联合腹横肌平面神经阻滞的效果,探讨其在术后康复中的作用。方法行剖宫产手术超体重产妇240例,随机分为观察组和对照组各120例。对照组椎管内麻醉采用常规髂嵴最高点连线定位法,于L_(2-3)间隙穿刺后注射质量分数0.75%布比卡因1.2~1.5mL;观察组在超声引导下于L_(2-3)间隙穿刺后注射质量分数0.75%布比卡因1.2~1.5mL,手术结束时于超声引导下行双侧腹横肌平面神经阻滞,注射质量分数0.375%盐酸罗哌卡因15mL+盐酸右美托咪定0.75μg/kg;2组术后自控静脉镇痛均应用舒芬太尼+酮洛酸氨丁三醇+盐酸阿扎司琼。记录2组麻醉穿刺时间、穿刺次数、首次自控镇痛时间、自控镇痛次数、术后泌乳时间、住院时间等;采用40项恢复质量量表(quality of recovery-40questionnaire,QoR-40)评分评估2组术后24h恢复情况;比较2组术前及术后24h催乳素、空腹血糖、去甲肾上腺素、白细胞介素-6(interleukin 6,IL-6)水平;多因素线性回归分析影响超体重产妇剖宫产术后QoR-40评分的因素。结果2组年龄、孕周、体质量指数、手术时间及术后下床时间比较差异均无统计学意义(P>0.05)。观察组麻醉穿刺时间[(78.1±20.2)s]、术后泌乳时间[(25.3±10.2)h]、术后通气时间[(10.7±6.1)h]、住院时间[(4.8±0.8)d]均短于对照组[(117.6±79.1)s、(33.1±12.9)h、(12.8±9.4)h、(5.0±0.8)d](t=5.300,P<0.001;t=5.177,P<0.001;t=2.046,P=0.040;t=2.023,P=0.040),穿刺次数[(1.3±0.5)次]、自控镇痛次数[(1.9±1.3)次]均少于对照组[(1.8±0.9)、(2.8±1.6)次](t=5.610,P<0.001;t=4.893,P<0.001),术后24hQoR-40评分[(192.0±9.8)分]高于对照组[(180.1±21.8)分](t=5.443,P<0.001)。观察组术前24h空腹血糖[5.20(4.50,5.60)mmol/L]、去甲肾上腺素[442.50(382.25,462.00)ng/L]、IL-6[5.37(4.56,5.90)ng/L]、催乳素[226.00(206.25,245.00)μg/L]水平与对照组[5.20(4.50,5.60)mmol/L、445.00(376.00,467.75)ng/L、5.37(4.56,5.82)ng/L、226.00(215.00,245.00)μg/L]比较差异均无统计学意义(P>0.05);观察组术后24h催乳素[400.50(387.00,418.00)μg/L]水平高于对照组[367.00(355.00,390.00)μg/L](U=8.26,P<0.001),空腹血糖[5.60(5.50,5.90)mmol/L]、去甲肾上腺素[521.00(467.00,545.75)ng/L]、IL-6[16.82(15.15,19.85)ng/L]水平均低于对照组[6.25(5.90,6.68)ng/L、606.00(556.00,645.00)ng/L、24.42(19.88,27.55)ng/L](U=-7.73,P<0.001;U=-8.76,P<0.001;U=-8.98,P<0.001);2组术后24h各指标均高于术前24h(P<0.05)。术后IL-6(β=-0.58,95%CI:-0.96~0.20,P=0.003)、麻醉穿刺时间(β=-0.04,95%CI:-0.07~0.01,P=0.021)、麻醉方式(β=5.36,95%CI:0.55~10.18,P=0.029)是超体重产妇剖宫产后QoR-40评分的影响因素。结论超体重产妇剖宫产术中应用超声引导下椎管内麻醉联合腹横肌平面神经阻滞可缩短术中麻醉穿刺时间,减少穿刺次数,减轻术后疼痛,促进术后快速康复。展开更多
文摘<b><span>Background: </span></b><span>After functional endoscopic nasal surgery, emergence agitation is not uncommon. The aim of this trial was to investigate the effect of perioperative lidocaine infusion on postoperative early recovery quality and incidence of emergence agitation in patient undergoing functional endoscopic sinus surgery.</span><span> </span><b><span>Study Design:</span></b><b><span> </span></b><span>Prospective, randomized, double-blinded, placebo-controlled trial.</span><span> </span><b><span>Methods: </span></b><span>100 patients of ASA I and II, aged 18</span><span> </span><span>-</span><span> </span><span>50 years, of both sexes scheduled for FEES, were assigned into two groups. In Group L;patients received an intravenous bolus infusion of 1.5</span><span> </span><span>mg/kg lidocaine just before induction of anesthesia followed by a continuous infusion of 2</span><span> </span><span>mg/kg/h during the operation and until the end of the surgery. In Group C;patients received normal saline infusion with the same volume as group L according to the same protocol. The primary endpoints were incidence of emergence agitation and postoperative recovery quality (QoR-40) score on first postoperative day (POD1).</span><span> </span><b><span>Results:</span></b><b><span> </span></b><span>Incidence of emergence agitation was significantly lower in group L (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) compared with group C. Global QoR-40 scores on POD1 w</span><span>ere</span><span> significantly lower in both groups compared with preoperative assessment, it was significantly higher in group L on POD1 (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) than in group C. Among the five dimensions of QoR-40, the scores for physical comfort and pain were superior in group L compared to group C (</span><i><span>P</span></i><span> < </span><span>0</span><span>.05) at POD1.</span><span> </span><b><span>Conclusion: </span></b><span>Systemic lidocaine infusion can improve </span><span>QoR-40 scores and decrease incidence of emergence agitation in patients scheduled</span><span> for FEES</span><span>,</span><span> also it reduce</span><span>s</span><span> the duration of stay in PACU after surgery.</span>
文摘目的观察超体重(孕前体质量指数≥25kg/m^(2))产妇剖宫产术中应用超声引导下椎管内麻醉联合腹横肌平面神经阻滞的效果,探讨其在术后康复中的作用。方法行剖宫产手术超体重产妇240例,随机分为观察组和对照组各120例。对照组椎管内麻醉采用常规髂嵴最高点连线定位法,于L_(2-3)间隙穿刺后注射质量分数0.75%布比卡因1.2~1.5mL;观察组在超声引导下于L_(2-3)间隙穿刺后注射质量分数0.75%布比卡因1.2~1.5mL,手术结束时于超声引导下行双侧腹横肌平面神经阻滞,注射质量分数0.375%盐酸罗哌卡因15mL+盐酸右美托咪定0.75μg/kg;2组术后自控静脉镇痛均应用舒芬太尼+酮洛酸氨丁三醇+盐酸阿扎司琼。记录2组麻醉穿刺时间、穿刺次数、首次自控镇痛时间、自控镇痛次数、术后泌乳时间、住院时间等;采用40项恢复质量量表(quality of recovery-40questionnaire,QoR-40)评分评估2组术后24h恢复情况;比较2组术前及术后24h催乳素、空腹血糖、去甲肾上腺素、白细胞介素-6(interleukin 6,IL-6)水平;多因素线性回归分析影响超体重产妇剖宫产术后QoR-40评分的因素。结果2组年龄、孕周、体质量指数、手术时间及术后下床时间比较差异均无统计学意义(P>0.05)。观察组麻醉穿刺时间[(78.1±20.2)s]、术后泌乳时间[(25.3±10.2)h]、术后通气时间[(10.7±6.1)h]、住院时间[(4.8±0.8)d]均短于对照组[(117.6±79.1)s、(33.1±12.9)h、(12.8±9.4)h、(5.0±0.8)d](t=5.300,P<0.001;t=5.177,P<0.001;t=2.046,P=0.040;t=2.023,P=0.040),穿刺次数[(1.3±0.5)次]、自控镇痛次数[(1.9±1.3)次]均少于对照组[(1.8±0.9)、(2.8±1.6)次](t=5.610,P<0.001;t=4.893,P<0.001),术后24hQoR-40评分[(192.0±9.8)分]高于对照组[(180.1±21.8)分](t=5.443,P<0.001)。观察组术前24h空腹血糖[5.20(4.50,5.60)mmol/L]、去甲肾上腺素[442.50(382.25,462.00)ng/L]、IL-6[5.37(4.56,5.90)ng/L]、催乳素[226.00(206.25,245.00)μg/L]水平与对照组[5.20(4.50,5.60)mmol/L、445.00(376.00,467.75)ng/L、5.37(4.56,5.82)ng/L、226.00(215.00,245.00)μg/L]比较差异均无统计学意义(P>0.05);观察组术后24h催乳素[400.50(387.00,418.00)μg/L]水平高于对照组[367.00(355.00,390.00)μg/L](U=8.26,P<0.001),空腹血糖[5.60(5.50,5.90)mmol/L]、去甲肾上腺素[521.00(467.00,545.75)ng/L]、IL-6[16.82(15.15,19.85)ng/L]水平均低于对照组[6.25(5.90,6.68)ng/L、606.00(556.00,645.00)ng/L、24.42(19.88,27.55)ng/L](U=-7.73,P<0.001;U=-8.76,P<0.001;U=-8.98,P<0.001);2组术后24h各指标均高于术前24h(P<0.05)。术后IL-6(β=-0.58,95%CI:-0.96~0.20,P=0.003)、麻醉穿刺时间(β=-0.04,95%CI:-0.07~0.01,P=0.021)、麻醉方式(β=5.36,95%CI:0.55~10.18,P=0.029)是超体重产妇剖宫产后QoR-40评分的影响因素。结论超体重产妇剖宫产术中应用超声引导下椎管内麻醉联合腹横肌平面神经阻滞可缩短术中麻醉穿刺时间,减少穿刺次数,减轻术后疼痛,促进术后快速康复。
