关键词: 利多卡因, 二异丙酚, 应激反应, 手术, 腹腔镜胆囊切除术

Abstract: AIM: To evaluate the influence of lidocaine on stress reaction.METHODS: Forty-five ASA Ⅰ-Ⅱ patients undergoing laparoscopic cholecystectomy were randomly divided into three groups:In group P anesthesia was induced and maintained with propofol given by TCI;In group L₁ and group L₂ anesthesia was induced and maintained with propofol and lidocaine infusion, loading dose of 1 and 2 mg/kg, respectively, then adding 1 and 2 mg·kg^-1·h^-1 for maintenance inspect.Targeteffect propofol concentration and recovery time were monitored. Plasma hydrocortisone, pancreatic glucagons and angiotensin Ⅱconcentration were determined before induction (T₀), after intubation (T₁), before operation (T₂), before pneumoperitoneum was ended (T₃) and after extraduction (T₄).RESULTS: Target-effect propofol concentration was higher in group P at every time than that in group L₁ and L₂ (P <0.05);Plasma hydrocortisone concentration was lower in group L₂ than that in group P at T₁, T₃ and T₄;Plasma pancreatic glucagons concentration was lower at T₃ and T₄ in group L₁ and L₂ than that in group P;Plasma angiotensin Ⅱconcentration was higher at T₁, T₂, T₃ and T₄ than that at T₀, but there was no difference in three groups.Recovery time was longer in group L₁ and L₂ than that in group P, and it was longer in group L₂ than that in group L₁.CONCLUSION: Lidocaine can decrease the target-effect propofol concentration and the stress reaction in operation, but it prolongs the recovery time.

Key words: lidocaine, propofol, stress reaction, laparoscopic cholecystectomy