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Zhang Jingwen,1 Kong Lingling,2 Juan11Dhipatimendi reAnesthesiology, West China Second Hospital, Sichuan University, Key Laboratory yeCongenital Defects uye Zvirwere Zvinoenderana, Ministry of Education, Sichuan University, Chengdu, Sichuan Province, 2Dhipatimendi reObstetrics uye Gynecology, West China Chechipiri Chipatara cheSichuan University, Kuremara kwekuzvarwa, Key Laboratory yeSichuan University yeDzidzo uye Zvirwere zvinoenderana neBazi reDzidzo, Chengdu, Sichuan Province Anowirirana munyori: Ni Huang, Dhipatimendi reAnesthesiology, West China Chechipiri Chipatara cheSichuan University, Key Laboratory yeCongenital Defects. uye Zvirwere zveMai neMwana zveBazi reDzidzo yeSichuan University, South San Renmin Road, Chengdu, Sichuan Province Duan 20, 610041 China, Tel +86 18180609890, Fax +86 28855503752, Email [email protected] Chinangwa: Ichi chidzidzo chakagadzirwa kuyedza iyo inoreva inoshanda dhizi (ED50) uye 95% inoshanda madhisi emutsinga lidocaine inopihwa pamitengo yakasiyana (ED95), mhedzisiro yeiyo induction dose yepropofol, uye kuona iyo yakakwana dhizi.Boka: saline (L0), lidocaine 0.5 mg / kg (L0.5), lidocaine 1.0 mg / kg (L1.0) uye lidocaine 1.5 mg / kg (L1.5).Kurudzira kutindivadza ne 1.0 µg/kg fentanyl.Yakagadzirirwa lidocaine kana saline inotungamirirwa gare gare sezvinorayirwa, inoteverwa nepropofol.Muyero wepropofol wemurwere wega wega wakatemerwa uchishandisa inoteedzana kumusoro-pasi kudzidza dhizaini.Mhedziso yekutanga yaive ED50 uye ED95 yepropofol induction dose. Zvose zvepropofol doses, nguva yekumuka, uye zviitiko zvakashata zvakanyorwa.Zvigumisiro: ED50 (95% nguva yekuvimba) yepropofol yakanga yakaderera zvikuru mumapoka L1.0 uye L1.5 kupfuura boka L0 (1.6 [1.5- 1.7] mg/ kg uye 1.8 [1.6- 1.9] mg / kg, maererano ne2.4 [2.3-2.5] mg / kg, maererano; p1.0 uye L1.5 (p> 0.05). .5 kupfuura L0 (2.8 [2.6– 3.0] mg/kg vs 2.4 [2.3– 2.5] mg/kg; p1.0 uye L1.5 dzakanga dzakaderera pane dziri mumapoka L0 uye L0.5 (p0.5 yakanga yakakura kudarika iyo muboka L0 (p0.5 yakanga yakakura kudarika iyo mumapoka L0 uye L1.0 (p Mhedziso: Muvarwere vakawana yekutanga-trimester uterine aspiration, intravenous lidocaine 1.0 mg / kg isati yasvika propofol injection yakaderedza zvakanyanya ED50 yepropofol induction dose pasina migumisiro yakakomba, yakaenzana nemigumisiro ye 1.5 mg / kg dose Tinokurudzira 1.0 mg / kg seyero yakakwana.Mazwi anokosha: lidocaine, propofol, uterine aspiration, yepakati inobudirira dose. Iyo yakazara propofol doses, nguva yekumuka, uye zviitiko zvakashata zvakanyorwa.Migumisiro: ED50 (95% nguva yekuvimba) yepropofol yakanga yakaderera zvikuru mumapoka L1.0 uye L1.5 kupfuura boka L0 (1.6 [1.5-1.7] mg / kg uye 1.8 [1.6-1.9] mg / kg, zvichienderana ne2.4 [2.3-2.5] mg/kg, maererano, p1.0 uye L1.5 (p> 0.05 .5 kupfuura L0 (2.8 [2.6-3.0] mg/kg vs 2.4 [2.3– 2.5] mg/kg; p1). .0 uye L1.5 yakanga yakaderera pane iyo iri mumapoka L0 uye L0.5 (p0.5 yakanga yakakura kudarika iyo muboka L0 (p0.5 yakanga yakakura kudarika iyo mumapoka L0 uye L1.0 (p Mhedziso: Muvarwere vakawana yekutanga-trimester uterine aspiration, intravenous lidocaine 1.0 mg / kg isati yasvika propofol jekiseni zvakanyanya kuderedza ED50 yepropofol induction dose pasina migumisiro yakakomba, yakaenzana nemigumisiro ye 1.5 mg / kg dose.Yese propofol doses, nguva yekumuka, uye zviitiko zvakashata zvakanyorwa.Migumisiro: ED50 (95% nguva yekuvimba) yepropofol yakanga yakaderera zvikuru muL1.0 uye L1.5 mapoka kupfuura muboka reL0 (1.6 [1.5-1, 7] mg / ml).кг uye 1,8 [1,6–1,9] мг/кг по сравнению с 2,4 [2,3–2,5] мг/кг соответственно, p1,0 uye L1,5 (p>0,05) ), однако, как ни удивительно, ED50 была значительно выше в группе L0. kg uye 1.8 [1.6-1.9] mg / kg inopesana ne2.4 [2.3-2.5] mg / kg, maererano, p1.0 uye L1.5 (p> 0.05), zvisinei, zvinoshamisa, ED50 yakanga yakakwirira zvikuru muboka reL0. .0.5 kupfuura L0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg; p1.0 uye L1.5 yakanga yakaderera kupfuura mumapoka L0 uye L0.5 (p0.5 yakakura kudarika mumapoka L0 neL0.5) iyo iri muboka L0 (p0.5 yakanga yakakura kudarika mumapoka L0 uye L1.0 (p Mhedziso: kune varwere vari kutarisana nechibereko chechirwere mukutanga kwekutanga, intravenous administration ye lidocaine pachiyero che 1.0 mg / kg zvisati zvaitika. jekiseni yepropofol yakaderedza zvakanyanya ED50 yehuwandu hwehuwandu hwepropofol)) pasina migumisiro yakakomba, yakaenzana nemigumisiro yechirwere che 1.5 mg / kg Tinokurudzira 1.0 mg / kg seyero yakakwana mazwi: lidocaine, propofol , uterine aspiration, zvinoreva dose inoshandaYese propofol dose, nguva yekumuka, uye zvakaipa zviitiko zvakanyorwa.结果:L1.0 和L1.5 组异丙酚的ED50（95% 置信区间）显着低于L0 组（1.6 [1.5–1.7]mg/9 mg,8mg/1.8mg/1. 2.4 [2.3–2.5] mg/kg;p1.0 和L1.5 (p> 0.05)。然而，令人惊讶的是，L0 组的ED50 显着更高.5 比L0 (2.3 [2.0]–2. mg/kg vs 2.4 [2.3– 2.5] mg/kg;p1.0 和L1.5 低于L0 和L0.5 组(p0.5 大于L0 组（p0.5 大于L0 和L1.0 结论（p) :在接受妊娠早期子宫抽吸术的患者中，丙泊酚注射前静脉注射利多卡因1.0 mg/kg/kg/阿显杀降了显着降了显杀降亚会会0）无严重副作用，相当于1.5 mg/kg剂量的效果。我們推荐1.0 mg/kg作為最剂量。关键词：利多卡因、丙泊酚、子宫抽吸、中位有效剂量结果: L1.0 和L1.5 组异丙酚的ED50（95% L0 mg/kg vs 2.4 [2.3–2.5] mg/kg;p1.0 和L1.5 ： 在 接受 妊期 早 早患者 中 丙泊 酚 注射 前 静脉 注射利多卡因 注射利多卡因 注射利卡因 注射着多卡因 注射利多卡因的 ed50） 严重 副作用 相当于 相当于 1.5 mg/kg 剂量的效果。我們推荐1.0 mg/kgMigumisiro: ED50 (95% nguva yekuvimba) yepropofol muL1.0 uye L1.5 mapoka akanga akaderera zvikuru kupfuura muboka reL0 (1.6 [1.5-1.7] mg/kg uye 1.8 [1, 6-1.9] mg /kg).кг соответственно 2,4 [2,3–2,5] мг/кг, p1,0 uye L1,5 (p>0,05) . в группе L0 (2,8 [2,6–2,6–2,6]). kg, maererano, 2.4 [2.3-2.5] mg / kg, p1.0 uye L1.5 (p> 0.05).Zvisinei, zvinoshamisa, ED50 yakanga yakakwirira zvikuru muboka reL0.5 kupfuura muboka L0 (2.8 [2.6-2.6-2.6]).3.0] mg/kg vs. 2.4 [2.3-2.5] mg/kg;p1.0 uye L1.5 yakanga yakaderera kupfuura mumapoka L0 uye L0.5 (p0.5 yakakura kudarika mumapoka L0 (p0.5 yakakura kupfuura L0 uye L1. 0 mapoka (p Mhedziso). : Muvarwere vechikadzi, Muvarwere kutarisana nefirst trimester uterine aspiration, intravenous lidocaine 1.0 mg/kg isati yaiswa propofol yakaderedza zvakanyanya ED50 yepropofol induction dose pasina migumisiro yakakomba, yakaenzana ne 1.5 mg / kg dose Tinokurudzira 1.0 mg / kg kg seyero yakakwana Keywords: lidocaine, propofol, uterine aspiration, zvinoreva dose inoshanda
Nekuda kwekuti propofol ine hafu yeupenyu hupfupi zvakanyanya pane mamwe madhiragi, propofol inowanzoshandiswa semutsinga wekutindivadza kuti ipe sedation panguva yekuvhiyiwa kwevarwere.1,2 Zvisinei, sedation ine chete yakakwirira doses yepropofol inobatanidza nekufema uye circulatory side effects.Kuwedzerwa kwepamusoro kwepropofol kunowedzera njodzi yekufema, kuparara kwemhepo yepamusoro, uye hypotension;3-7 nepo madosi mashoma anokonzera kusakwana sedation.Propofol pamwe chete nemimwe mishonga inoderedza njodzi yekufema uye kutenderera kweropa uye inopa yakachengeteka uye inogutsa sedative mhedzisiro.Nokudaro, pane chido chemubatsiri anobudirira kuderedza mhinduro yekuvhiyiwa uye kuderedza kudiwa kwepropofol.Mumakore achangopfuura, zvose midazolam uye dexmedetomidine zvakashandiswa mukuvhiyiwa kwekunze, asi hafu yeupenyu ye midazolam yakareba, induction ye dexmedetomidine inononoka, uye mushonga wacho wakawanda, saka kushandiswa kunogumira.8.9
Lidocaine inoshandiswa zvakanyanya munharaunda yeanesthetic mumakiriniki.10 Ongororo dzakapfuura dzakawana kuti intravenous lidocaine inogona kuwedzera sedative effect ye propofol-based anesthesia.11-15 Zvimwe zvikomborero zveparioperative ye intravenous lidocaine zvinosanganisira kuderedza marwadzo ejekiseni repropofol, kuderedza kudiwa kweopioid, kukurumidza kupora kwegastrointestinal basa mushure mekuvhiyiwa, uye kuderera kwechiitiko chekurwadziwa kusingaperi kwepashure.16-19 Intravenous lidocaine ine hafu yeupenyu hupfupi (90-120 min), uye huwandu hweropa hwayo hwakataurwa muzvidzidzo zvekiriniki hwakaramba huri pasi pehuwandu hwehupfu (> 5 μg /mL) .20,21 Foo et al yakakurudzirwa mumitemo yavo yebvumirano ichangobva kudhindwa kuti kana intravenous lidocaine yakashandiswa, chiyero chekutanga chisingapfuuri 1.5 mg / kg chakaverengwa uchishandisa uremu hwemurwere hwakachengeteka.21 Chidzidzo chaLili et al akatoratidza kuti kutungamirirwa kwe bolus intravenous lidocaine 1.5 mg / kg isati yasvika anesthesia induction yakaguma ne 36% kuderedza ED50 ye propofo. Лидокаин является широко используемым местным анестетиком в клинической практике.Предыдущие исследования показали, что внутривенное введение лидокаина может усиливать седативный эффект анестезии на основе пропофоф.ускоренное восстановление желудочно-кишечного тракта после операции и снижение частоты послеоперационной хронической–19 и песни ет короткий период полувыведения (90–120 мин), а его концентрация в крови, зарегистрированная в клинических исследования конценское, концентрация в крови 5 мкг)./мл)20,21 Foo et al.в своих недавно опубликованных согласованных рекомендациях рекомендовали, чтобы при внутривенном введении лидокаина начальная 1, песни начальников 21 Исследование Lili uye др.уже доказали, что болюсное внутривенное введение лидокаина в дозе 1,5 мг/кг перед индукцией анестезии приводит книж30 %.利多卡因是临床实践中广泛使用的局部麻醉剂。 10 先前镇静作用。 11-15 静脉注射利多卡因的其他围手术期益处包括减轻异丙酚注射疼痛、减少阿片类药物需求、术后胃肠功能加速恢积复，术后胃肠功能加速恢积复，降低。 16-19 静脉注射利多卡因半衰期短（90-120 分钟），临床研究报告的其血液浓度仍低于毒性浓度（>5 µg /mL).20,21 Foo 等人在他們新发表的共识指南中建论言，因此识指南中建识，因，使用患者理想体重计算的初始剂量不超过 1.5 mg/kg 是安全的。21 Lili 的一项研等人已经证明，在麻醉诱导前静脉推注利多卡時 1.5 mg/10 kg 1.5 mg/ 36%利多卡 因 临床 实践 中广泛 使用 的局部 麻醉剂。 10 先前 研究发现麻醉 镇静 作用。 11-15 静脉的其他 手术 期益处注射 疼痛 , 减少 阿片类 药物 需求 , 术后 胃肠 恢复 , 术后 慢性 疼 兢复9 静脉 因 半衰期 短 (90-120 分钟).毒性 浓度 （(> 5 мкг /мл).20,21 foo 等 在他們新 发表 的识 指南 中 建议 , 使用静脉 静脉 注脉 注脉计算 的 初始剂量 不 如果 静脉 , 患者 理想 计算 的 不 不 不如果 注射利多卡因 患者 理想 计算的 不 不超过 1,5 мг/кг 是 安全。 。诱导 前 推注利多卡因 推注利多卡因 1,5 мг /кг 可 丙泊 酚的 ed50 降低 36%手术 患者 对 宫颈 扩张的 反应多卡 可 显着 成人 患者 检查 期间 异丙酚 诱导剂量的 ed50 , 而 而而 而 而 而 患者 检查 异丙酚 诱导剂量的 的 , , 不会显着影响血区亚响血流家和3.
Naizvozvo, chidzidzo ichi chine chinangwa chekuyedza mhedzisiro yemadhizi akasiyana eiyo intravenous lidocaine paED50 uye ED95 yepropofol-inducing doses panguva yekutanga trimester uterine aspiration, pamwe nekuona iyo yakakwana dose, iyo, sekuziva kwedu, isati yadzidzwa. muzvidzidzo zvakapfuura..
Mushure mekupedza dhizaini yekuyedzwa kwekiriniki iyi, takasvetuka ongororo yetsika yeWest China Second Hospital, uye inotevera ichine mwedzi mishoma kuti isvike.Naizvozvo, takatsvaga kuongororwa kwetsika kubva kuChina Clinical Trials Registration Ethics Committee, komiti yakazvimirira yetsika yemasangano yakarongwa neChina Clinical Trials Registration Center.Iyi protocol yeongororo yakabvumidzwa neEthics Committee yeChinese Clinical Trials Registry (ChiECCRCT20210401) uye yakanyoreswa neChinese Clinical Trials Registry (ChiCTR2100049263).Chidzidzo ichi chakaitwa maererano neDeclaration yeHelsinki kubva munaGunyana 2021 kusvika Chivabvu 2022, uye takawana mvumo yakanyorwa kubva kune zana vatori vechikamu chidzidzo chisati chatanga.
Ichi chidzidzo chinotarisirwa chakaitwa muvarwere vechikadzi vakarongerwa kuitiswa trimester outpatient hysteroscopy pasi peanesthesia yeSichuan University West China Second Hospital.Chidzidzo chacho chaisanganisira varwere vane ASA chimiro chemuviri I kana II, vane makore 18-50 uye vakatsanya kwemaawa 6 (zvakaoma) uye maawa 2 (mvura) vasati vavhiyiwa. Nzira dzekuregererwa dzaive dzakadai: varwere vane body mass index (BMI)> 28 kg / m2 kana BMI <18 kg / m2; Nzira dzekuregererwa dzaive dzakadai: varwere vane body mass index (BMI)> 28 kg / m2 kana BMI <18 kg / m2; Критерии исключения были следующими: пациенты с индексом массы тела (ИМТ) >28 кг/м2 или ИМТ <18 кг/м2; Nzira dzekuregererwa dzaive dzakadai: varwere vane body mass index (BMI)> 28 kg / m2 kana BMI <18 kg / m2;排除标准如下：体重指数（BMI）>28 kg/m2或BMI<18 kg/m2的患者;排除标准如下：体重指数（BMI）>28 kg/m2或BMI<18 kg/m2的患者; Критерии исключения: пациенты с индексом массы тела (ИМТ) > 28 кг/м2 или ИМТ < 18 кг/м2; Maitiro ekuregeredza: varwere vane body mass index (BMI)> 28 kg / m2 kana BMI <18 kg / m2; varwere vane uremu hwemuviri <40 kg; varwere vane uremu hwemuviri <40 kg; пациенты с массой тела <40 кг; varwere vanorema <40 kg;体重<40公斤的患者;体重<40公斤的患者; Пациенты с массой тела < 40 кг; Varwere vanorema <40 kg;Varwere vane vaginal kusununguka uye nhoroondo yekervical dilatation mukati me6 mwedzi;varwere vane allergic kune anesthetics yemunharaunda, propofol, fentanyl, kana mamwe madhiragi ane chokuita nechidzidzo ichi;varwere vane hepatic yakanyanya uye renal insufficiency, endocrine zvirwere, varwere vane metabolic kusagadzikana, chirwere chemwoyo, zvirwere zvekufema system kana zvirwere zvepakati tsinga Kushandisa kwenguva refu sedatives, analgesics, zvinodhaka zvinogona kukanganisa metabolism yeanesthetics yemunharaunda kana varwere mukati memazuva e7 Vakagamuchira zvimwe zviedzo mukati memwedzi ye3 isati yatanga kudzidza Mishonga kana varwere vakapinda mune mamwe makiriniki ekuedzwa;varwere vakapindwa muropa nedoro kana kuti zvinodhaka zvokuzvivaraidza nazvo;varwere vane Mallampati III-IV zvibodzwa.Vese vatori vechikamu vakaziviswa nezvechinangwa chechidzidzo.
Nenguva pfupi, varwere ve100 vakagadziriswa mumapoka L0, L0.5, L1.0, uye L1.5 maererano nekombuta-yakagadzirwa random sequence ine block size ye 4. Nhamba yakasiyana-siyana yakavharwa mu envelope isina opaque.Anesthesiologists vanogadzira nekupa zvinodhaka vanoziva mabasa eboka.Vatsvagiri, varwere, vanachiremba vekuvhiya, uye vanamukoti vakaunganidza data vaive bofu.
Hapana mimwe mishonga yaishandiswa kusati kwaitwa anesthesia.A 22 gauge cannula akaiswa mutsinga uye Ringer's lactate infusion (2 ml/kg/h) yakatanga.Paakapinda muimba yekushanda, murwere akapiwa inhalation yeokisijeni kuburikidza nemasikisi pamwero we10 L / min kwemaminetsi e3 isati yaiswa, uye invasive blood pressure, electrocardiogram, kufema kwemhepo, uye peripheral capillary oxygen saturation (SpO2) yakaongororwa. kusvikira murwere asunungurwa.kubva kune anesthesia.uye akatamisirwa munguva yekuvhiyiwa kudhipatimendi reanesthesia.SpO2, kurova kwemoyo (HR) uye kupindira kweropa kweropa zvakanyorwa panguva nhatu dzinotevera: panguva yekugadzirira induction yeanesthesia (T0), pamagumo ekuiswa kweanesthesia (T1), pamagumo ekuwedzera kwekervical dilatation. (T2).Zvose zvakagadzirirwa zvakagadzirirwa patembiricha yekamuri.tembiricha, kuchengetwa uye kushandiswa pakarepo.Lidocaine (Sinopharm Rongsheng Pharmaceutical Co., Ltd.) 0.5 mg / kg, 1.0 mg / kg uye 1.5 mg / kg yakaderedzwa kusvika 10 ml nesaline mune sirinji ye10 ml.Gadzirawo huwandu hwakaenzana hwesaline musirinji ine 10 ml.Nhanganyaya yeanesthesia yakatangwa nejekiseni rimwechete re bolus re fentanyl 1.0 μg/kg (Yichang Renfu Pharmaceutical Co., Ltd., China).Kwapera miniti, lidocaine yakagadzirira kana saline yakashandiswa sezvinorayirwa kweanenge masekondi makumi matatu, uye ipapo propofol (Corden Pharma SPA, Italy) yakapiwa kuvarwere vose pamwero we0.4 ml / s.Murwere wekutanga muboka rimwe nerimwe akagamuchira propofol 2.0 mg/kg.Mune varwere vanotevera, chirwere chepropofol chakawedzerwa kana kuderedzwa ne 0.2 mg / kg, zvichienderana nemhinduro yemurwere wekare.Iyo Modified Observer Alertness/Sedation Rating Scale (MOAA/S) yakashandiswa kuongorora hudzamu hwekunyaradza.24 Chikero cheMOAA/S chikero che 6-point uye chinotsanangurwa se 5: zita riri nyore kududza nezwi rinogara riripo;4: kubatwa nehope kune zita rinodudzwa nenzwi rakajairika;3: chete neruzha uye/kana kudzokorora mhinduro mushure mekudaidza zita;2: mhinduro chete kune nyoro kukurudzira kana kudedera;1: mhinduro chete kune kurwadza kunorwadza kwe trapezius muscle;0: hapana mhinduro kune trapezius muscle contraction. Mushure mokunge chikamu cheMOAA / S chakanga chiri <1, chiremba anovhiya akabvumirwa kutanga kuiswa kwevaginal speculum, iyo yakaratidza kutanga kwekushanda. Mushure mokunge chikamu cheMOAA / S chakanga chiri <1, chiremba anovhiya akabvumirwa kutanga kuiswa kwevaginal speculum, iyo yakaratidza kutanga kwekushanda. После того, как оценка MOAA/S была <1, хирургу было разрешено начать установку вагинального зеркала, что сигнализировало о началее. Kamwe chibodzwa cheMOAA/S chaive <1, chiremba anovhiya akabvumidzwa kutanga kuisa speculum yemukadzi, zvichiratidza kutanga kwekuvhiya.在MOAA/S 评分<1 后，外科医生被允许开始放置阴道窥器，這标志着手术的开始.在 MOAA/S После того, как оценка MOAA/S <1, хирургу было разрешено начать установку вагинального зеркала, что ознаменовало начало процедур. Kamwe chikamu cheMOAA / S chaive <1, chiremba anovhiya akabvumidzwa kutanga kuisa speculum yemukadzi, zvichiratidza kutanga kwemaitiro.Kuvhiya kwese kunoitwa nachiremba mumwe chete.Chigumisiro chacho chaionekwa sechisina kukodzera kana MOAA / S yaiva ≥1 mushure mekutanga kwepropofol kana kana kufamba kwemakumbo kwakaonekwa kubva pakutanga kusvika kune cervical dilatation;zvikasadaro, muuyo wacho wakarangarirwa kuva unokosha.Muzviitiko zvisingabatsiri, muyero wepropofol wakawedzerwa ne 0.2 mg / kg muvarwere vanotevera.Propofol yakaderedzwa ne 0.2 mg / kg muvarwere vanotevera kune zviitiko zvinobudirira.Kana MOAA/S iri ≥1 kana kufamba kwemakumbo kunoonekwa panguva yekuvhiyiwa, propofol 0.5–1.0 mg/kg inopiwa maererano nezvinodiwa nekliniki.Mushure mokuiswa kweanesthesia, kana nguva yepnea yakapfuura 1 min, yakatsanangurwa sekuora mwoyo kwekufema uye mechanical ventilation yakaitwa kusvikira kufema kwepamuviri kwadzorerwa.Kana kuvharika kwenzira yekumusoro kuchionekwa, simudza rushaya rwezasi kuti ubvumire kufefetedza. Kana SpO2 <92%, hypoxia yakatsanangurwa uye maitiro akamiswa, uye yakabatsirwa kumeso kwemask ventilation yakashandiswa kugadzirisa iyo oxygen saturation. Kana SpO2 <92%, hypoxia yakatsanangurwa uye maitiro akamiswa, uye yakabatsirwa kumeso kwemask ventilation yakashandiswa kugadzirisa iyo oxygen saturation. При SpO2 <92% определяли гипоксию и процедуру прекращали, а для нормализации сатурации кислородом применяли прекращали вспомогательенуну гких. PaSpO2 <92%, hypoxia yakatemwa uye maitiro akamiswa, uye yekubatsira kumeso kwemask ventilation yakashandiswa kugadzirisa oxygen saturation.如果SpO2 < 92%，则定义為缺氧并停止手术，并应用辅助面罩通气以使氧饱和度正常化。如果SpO2 < 92%，则定义為缺氧并停止手术，并应用辅助面罩通气以使氧饱和度正常化。 Если spo2 <92%, ппределите примиляцц пракеляц Ния кис кия кло Kana SpO2 <92%, sarudza hypoxia uye womisa kuvhiya, uye pinza mweya nemask kuti ugadzirise kuzara kweokisijeni. Kana iyo HR yaive <50 beats/min, atropine 0.5 mg yaipihwa. Kana iyo HR yaive <50 beats/min, atropine 0.5 mg yaipihwa. Если ЧСС <50 уд/мин, вводили атропин 0,5 мг. Kana kurova kwemoyo <50 bpm, atropine 0.5 mg yakaitwa.如果HR <50 次/分钟，则给予阿托品0.5 mg.如果HR<50次/分钟，则给予阿托品0.5 mg. Если ЧСС <50 уд/мин, введите 0,5 мг атропина. Kana mwoyo uchirova <50 bpm, ipa 0.5 mg atropine. Hypotension yakatsanangurwa seSBP, diastolic blood pressure (DBP), kana kureva arterial pressure (MAP) yakaderera nepamusoro pe20% yepakutanga, kana SBP <80 mmHg. Hypotension yakatsanangurwa seSBP, diastolic blood pressure (DBP), kana kureva arterial pressure (MAP) yakaderera nepamusoro pe20% yepakutanga, kana SBP <80 mmHg. Гипотензия определялась как снижение САД, диастолического артериального давления (ДАД) или среднего артериального давления (САД) боления 200 безплатно или САД <80 мм рт.ст. Hypotension yakatsanangurwa sekuderera kweSBP, diastolic blood pressure (DBP), kana kureva arterial pressure (MAP) nepamusoro pe20% yekutanga, kana SBP <80 mmHg.徒张压(DBP) 或平均动脉压(MAP) 下降超过基线的20%，或SBP<80 mmHg. 20%, SBP <80 mmHg. Гипотензию определяли как снижение более чем на 20% от исходного уровня САД, диастолического артериального давления (ДАнельного давления (ДАнельного) давления (ДАнельного) давления (ДАнельного) САД <80 мм рт.ст. Hypotension yakatsanangurwa sekuderera kweanopfuura 20% kubva pakutanga muSBP, diastolic blood pressure (DBP), kana kureva arterial pressure (MAP), kana SBP <80 mmHg.Kana hypotension ikaitika, 0.2-0.4 mg ye metahydroxylamine kana 5-10 mg ye ephedrine inotungamirirwa, zvichienderana nemamiriro ezvinhu.Iyo yakazara propofol dose, nguva yekushanda, uye nguva yekudzorera pakupera kwebasa zvakanyorwa.Myoclonus nemigumisiro yeanesthetics yemunharaunda yakataurwa zvakare, senge tinnitus, perioral numbness, uye palpitations inotevera propofol.
Mhedziso yekutanga yaive ED50 uye ED95 yepropofol induction dose.Secondary endpoints yaiva yakazara propofol dose, postoperative recovery time, kufema kuora mwoyo, kuvharidzirwa kwepamusoro kwemhepo, hypoxia, bradycardia, hypotension, uye postpropofol myoclonus.
Kuzvimirira uye kuparadzirwa kusingazivikanwe kwedata rakadzidzwa kumusoro-pasi kutevedzana maitiro kunoita kuti zviome kugadzira dzidziso dzakaomarara mitemo yekuverenga saizi yemuenzaniso.25 Saizi yemuenzaniso yakatemwa nemutemo wekumisa.Varwere vanofanirwa kunyoreswa vasati vasvika paviri peya nhanhatu dzemhedzisiro dzashandurwa kuita mhinduro dzinoshanda.Zvidzidzo zvekutevedzera zvakaratidza kuti, muzviitiko zvakawanda, kubatanidzwa kweinenge 20-40 varwere vanogona kupa yakagadzikana fungidziro yeinotarirwa dose.Mimwe miedzo yeanesthesia inoshandisa nzira iyi inowanzobatanidza 20-40 varwere.26,27 Muchidzidzo chedu, boka rimwe nerimwe raisanganisira varwere ve25, iyo yakanga yakakwana yekuongorora nhamba.
SPSS 26.0 (IBM Inc., Armonk, NY, USA) yakashandiswa kuongorora zvabuda.Iyo Shapiro-Wilk bvunzo yakashandiswa kuona kugoverwa kwakajairika kwedata.Zvimiro zvinoramba zvichigoverwa zvakaratidzwa sezvinoreva ± kutsauka kwakajairwa uye zvichienzaniswa pakati pemapoka anoshandisa nzira imwe ANOVA.Data isingawanzo kugovaniswa yakaunzwa seyepakati (interquartile range) uye ikaenzaniswa nekushandisa Wilcoxon rank sum test.Categorical data inoratidzwa se n (%) uye yakaongororwa uchishandisa chi-square bvunzo.Iyo ED50 (95% CI) yepropofol yakaverengerwa senzira yepakati ye zero yakakosha crossover uchishandisa nzira imwe ANOVA neBonferroni's nzira yekuenzanisa pakati pemapoka.ED95 (95% CI) yakafungidzirwa kushandisa probabilistic regression. Pakuongorora kwese, p <0.05 yaionekwa senge inoratidza mutsauko wakakosha. Pakuongorora kwese, p <0.05 yaionekwa senge inoratidza mutsauko wakakosha. Для всех анализов считалось, что p<0,05 указывает на статистически значимые различия. Pakuongorora kwese, p <0.05 yaifungidzirwa kuratidza mutsauko wakakosha.对于所有分析，p<0.05 被认為表明有统计学意义的差异. p<0.05 被认為表明有统计学意义的差异. Для всех анализов считалось, что p<0,05 указывает на статистически значимое различие. Pakuongorora kwese, p <0.05 yaifungidzirwa kuratidza mutsauko wakakosha.
Varwere vanosvika zana nemakumi maviri nemumwe vakanyoreswa nekuongororwa.Pakati peizvi, varwere ve100 vakagadziriswa mumapoka e4 uye vakabatanidzwa mukuongorora kwekupedzisira (Mufananidzo 1).Maitiro ekutanga emapoka mana evarwere, kusanganisira zera, BMI, chiyero chemoyo (T0), SBP (T0), DBP (T0) uye SBP (T0), haina kusiyana zvakanyanya (Tafura 1).
Kutevedzana kwepamusoro-pasi kunoratidza dose uye mhinduro yevarwere inoratidzwa pasi apa (Mufananidzo 2).Zvinorehwa propofol infusion doses muL0, L0.5, L1.0, uye L1.5 mapoka aive 2.3±0.2, 2.7±0.3, 1.6±0.2, uye 1.7±0.2 mg / kg, zvichiteerana.Pamusoro pemuonde.3 inoratidza kuongororwa kwemhinduro yepimo ye lidocaine uye propofol mumapoka mana evarwere.Tafura 2 inoratidza iyo ED50 uye ED95 (95% CI) yepropofol yemaoko mana, zvichibva paDixon-Massey ordinal kumusoro-pasi kurongeka uye mukana wekudzora, zvichiteerana. Iyo ED50 yepropofol mumapoka L1.0 uye L1.5 yakanga yakanyanya kuderera pane iyo muboka L0 (1.6 [1.5-1.7] mg/kg; 1.8 [1.6-1.9] mg/kg vs 2.4 [2.3-2.5] mg/ kg, p<0.001). Iyo ED50 yepropofol mumapoka L1.0 uye L1.5 yakanga yakanyanya kuderera pane iyo muboka L0 (1.6 [1.5-1.7] mg/kg; 1.8 [1.6-1.9] mg/kg vs 2.4 [2.3-2.5] mg/ kg, p<0.001).ED50 yepropofol muL1.0 uye L1.5 mapoka akanga akaderera zvikuru kupfuura muboka reL0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg).kg maringe ne2.4 [2.3–2.5] mg/kg).кг кг, р<0,001). kg kg, p<0.001). L1.0 和L1.5 组异丙酚的ED50 显着低于L0 组（1.6 [1.5–1.7] mg/kg;1.8 [1.6–1.9] mg/kg vs 2.4 [2.3–2.5] mg/kg/kg ,p <0.001). L0 ,p <0.001).Iyo propofol ED50 yakanga yakaderera zvakanyanya muL1.0 uye L1.5 mapoka kupfuura muboka reL0 (1.6 [1.5-1.7] mg / kg; 1.8 [1.6-1.9] mg / kg).kg maringe ne2.4 [2.3–2.5] mg/kg)./кг кг, p <0,001). /kg kg, p <0.001). Kukosha kweED50 kwaive kwakakwirira muboka L0.5 kupfuura muboka L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg, p <0.05). Kukosha kweED50 kwaive kwakakwirira muboka L0.5 kupfuura muboka L0 (2.8 [2.6-3.0] mg / kg vs 2.4 [2.3-2.5] mg / kg, p <0.05). Величина ED50 была выше в группе L0,5, чем в группе L0 (2,8 [2,6–3,0] мг/кг против 2,4 [2,3–2,5] мг/кг, p<0 ,05). ED50 yakanga yakakwirira muboka reL0.5 kupfuura muboka reL0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg, p <0 .05). L0.5 组的ED50 值高于L0 组（2.8 [2.6-3.0] mg/kg vs 2.4 [2.3-2.5] mg/kg,p<0.05）. L0.5 组的ED50 值高于L0 组（2.8 [2.6-3.0] mg/kg vs 2.4 [2.3-2.5] mg/kg,p<0.05）. Группа L0,5 имела более высокие значения ED50, чем группа L0 (2,8 [2,6–3,0] мг/кг против 2,4 [2,3–2,5] мг/кг, p<0, 05). Iboka reL0.5 raiva nepamusoro ED50 maitiro kupfuura boka reL0 (2.8 [2.6-3.0] mg / kg vs. 2.4 [2.3-2.5] mg / kg, p <0, 05). Pakanga pasina misiyano yakakosha muED50 yepropofol pakati pemapoka L1.0 uye L1.5 (p> 0.05). Pakanga pasina misiyano yakakosha muED50 yepropofol pakati pemapoka L1.0 uye L1.5 (p> 0.05). Не было существенной разницы в ED50 пропофола между группами L1.0 и L1.5 (p>0,05). Pakanga pasina musiyano wakakosha mu propofol ED50 pakati peL1.0 neL1.5 mapoka (p> 0.05). L1.0组和L1.5组异丙酚的ED50差异无统计学意义（p>0.05）. L1.0组和L1.5组异丙酚的ED50差异无统计学意义（p>0.05）. Не было существенной разницы в ED50 пропофола между группой L1.0 и группой L1.5 (p>0,05). Pakanga pasina misiyano yakakosha mu propofol ED50 pakati peboka reL1.0 neboka reL1.5 (p> 0.05).
Tafura 2 ED50 uye ED95 (95% CI) yemapoka mana epropofol akavakirwa padanho repamusoro uye rezasi Dixon-Massey kugovera uye Probit regression.
Mufananidzo 2 Dixon kumusoro uye pasi pemapoka mana.“●” zvinoreva kushanda, “○” zvinoreva kusashanda.
Pakanga pasina misiyano yakakura pakati pemapoka munguva yekuvhiya uye nguva yekumuka sezvakanyorwa muTebhu 3 (p> 0.05). Pakanga pasina misiyano yakakura pakati pemapoka munguva yekuvhiya uye nguva yekumuka sezvakanyorwa muTebhu 3 (p> 0.05). Не было никаких существенных различий между группами в продолжительности операции и времени пробуждения, как указано в 3бли>0. Pakanga pasina misiyano yakakura pakati pemapoka panguva yekushanda uye nguva yekumuka, sezvakaratidzwa mutafura 3 (p> 0.05).各组手术时间和苏醒时间差异无统计学意义（p>0.05），见表3. p>0.05）,见表3. Не было существенной разницы во времени работы и времени пробуждения между группами (p>0,05), как показано в таблице 3. Pakanga pasina mutsauko wakakura munguva yebasa uye nguva yekumuka pakati pemapoka (p> 0.05), sezvakaratidzwa muTebhu 3. Izvo zviyero zvehuwandu hwepropofol inodiwa pakuvhiyiwa kwese yakanga yakakura zvikuru mumapoka L0 uye L0.5 kupfuura mamwe mapoka maviri (p <0.05, Tafura 3). Izvo zviyero zvehuwandu hwepropofol inodiwa pakuvhiyiwa kwese yakanga yakakura zvikuru mumapoka L0 uye L0.5 kupfuura mamwe mapoka maviri (p <0.05, Tafura 3). Средние про пробходии, были з вышете в 3). Izvo zviyero zvehuwandu hwepropofol inodiwa pakushanda kwese yakanga yakakwirira zvikuru mumapoka eL0 neL0.5 kupfuura mune mamwe mapoka maviri (p <0.05, Tafura 3).整个手术所需的总丙泊酚平均剂量在L0 和L0.5 组显着高于其他两组（p<0.05，表3）.整个手术所需的总丙泊酚平均剂量在L0和L0.5 Средняя доза общего пропофола, необходимая для всей процедуры, была значительно выше пропофола, необходимая для всей процедуры, была значительно выше в группах L0 и L0,5, чем др,пум таблица 3). Chiyero chechidimbu chepropofol inodikanwa kune iyo yose nzira yakanga yakakwirira zvikuru mumapoka eL0 neL0.5 kupfuura mune mamwe mapoka maviri (p <0.05, Tafura 3). Pakange pasina misiyano yakakosha pakati pemapoka mukuitika kwekuvharirwa kwemhepo yepamusoro (p> 0.05). Pakange pasina misiyano yakakosha pakati pemapoka mukuitika kwekuvharirwa kwemhepo yepamusoro (p> 0.05). Существенных различий между группами по частоте возникновения обструкции верхних дыхательных путей не было (p>0,05). Pakange pasina misiyano yakakosha pakati pemapoka mune chiitiko chekumusoro kuvharika kwemhepo (p> 0.05).上气道阻塞发生率组间差异无统计学意义（p>0.05）.上气道阻塞发生率组间差异无统计学意义（p>0.05）. Достоверной разницы в частоте обструкции верхних дыхательных путей между группами не было (p>0,05). Pakanga pasina misiyano yakakosha muchiitiko chekuvharwa kwemhepo yepamusoro pakati pemapoka (p> 0.05). Chiitiko chekuora mwoyo kwekufema muboka reL0.5 chaiva chikuru kudarika icho mumapoka L0 uye L1.0 (p <0.05). Chiitiko chekuora mwoyo kwekufema muboka reL0.5 chaiva chikuru kudarika icho mumapoka L0 uye L1.0 (p <0.05). Частота угнетения дыхания в группе L0,5 была выше, чем в группах L0 uye L1,0 (p<0,05). Kuwanda kwekuora mwoyo kwekufema muboka reL0.5 kwaive kwakakwirira kudarika muL0 uye L1.0 mapoka (p <0.05). L0.5组呼吸抑制发生率高于L0,L1.0组（p<0.05）. L0.5组呼吸抑制发生率高于L0,L1.0组（p<0.05）. Частота угнетения дыхания в группе L0,5 была выше, чем в группах L0 uye L1,0 (p<0,05). Kuwanda kwekuora mwoyo kwekufema muboka reL0.5 kwaive kwakakwirira kudarika muL0 uye L1.0 mapoka (p <0.05). Pakanga pasina misiyano yakakosha pakati pemapoka mukuitika kwe hypotension (p> 0.05), asi kuderera kweSBP mushure mekuiswa kweanesthesia muboka L0.5 yakanga yakakura kudarika iyo muboka L0 (p <0.01). Pakanga pasina misiyano yakakosha pakati pemapoka mukuitika kwe hypotension (p> 0.05), asi kuderera kweSBP mushure mekuiswa kweanesthesia muboka L0.5 yakanga yakakura kudarika iyo muboka L0 (p <0.01). Достоверных различий между группами по частоте гипотензии не было (p>0,05), но снижение САД после индукции анестезипип,05 группе L0 (p <0,01). Kwakange kusina kusiyana kwakasiyana pakati pemapoka muchiitiko che hypotension (p> 0.05), asi kuderera kweSBP mushure mekuiswa kweanesthesia kwaiva kukuru muboka reL0.5 kupfuura muboka reL0 (p <0.01).低血压发生率组间差异无统计学意义（p>0.05），但L0.5组麻醉诱导后SBP丅L0険义（大SBP丅L0険义义但L0.5).低血压发生率组间差异无统计学意义（p>0.05），但L0.5组麻醉诱导后SBP下L0険廄）大SBP丅度0険廄）但L0.5组麻醉诱导后SBP下L0険约廄 Не было существенной разницы в частоте гипотензии между двумя группами (p>0,05), но снижение САД после индукции плуппами, 5. чем в группе L0 (p<0,01). Ikoko kwakanga kusina misiyano inokosha muchiitiko che hypotension pakati pemapoka maviri (p> 0.05), asi kuderedzwa kweSBP mushure mekuiswa kweanesthesia kwaiva kukuru muboka reL0.5 kupfuura muboka reL0 (p <0.01).Hapana wevarwere akagadzira bradycardia uye hypoxia.Hapana murwere akashuma kurutsa, tinnitus, perioral numbness, uye palpitations.Murwere #20 muboka reL1.0 akagadzira myoclonus yechiso mushure mekutanga kwepropofol 1.8 mg / kg, uye murwere #10 muboka L1.5 akagadzira myoclonus yechiso nemakumbo mushure mekutanga kwepropofol 1.4 mg / kg..Myoclonus inomira mushure memasekondi 30-60. Pakanga pasina misiyano yakakosha pakati pemapoka mune chiitiko chemyoclonus (p> 0.05). Pakanga pasina misiyano yakakosha pakati pemapoka mune chiitiko chemyoclonus (p> 0.05). Достоверных различий между группами по частоте миоклонуса не было (p>0,05). Pakanga pasina misiyano yakakosha pakati pemapoka mune chiitiko chemyoclonus (p> 0.05).肌阵挛发生率组间差异无统计学意义（p>0.05）.肌阵挛发生率组间差异无统计学意义（p>0.05）. Достоверной разницы в частоте миоклонуса между группами не было (p>0,05). Pakanga pasina misiyano yakakosha muhuwandu hwemyoclonus pakati pemapoka (p> 0.05).
Sekuziva kwedu, iyi ndiyo yekutanga inotarisirwa kudzidza inoratidza mhedzisiro yeakasiyana madosi eintravenous lidocaine paED50 uye ED95 yeiyo induction dose yepropofol muvarwere vari kutanga trimester hysteroscopy.Zvigumisiro zvakaratidza kuti intravenous administration ye lidocaine pachiyero che 1.0 mg / kg pamberi pejojo ​​yepropofol yakaderedza zvakanyanya ED50, ED95 uye yakazara propofol dose, iyo yakaenzana nemigumisiro yepimo ye 1.5 mg / kg.Naizvozvo isu tinokurudzira dhigirii yakaderera ye1.0 mg/kg seyakanyanya dhizi yeanoshanda adjunctive therapy ye intravenous anesthesia ine propofol.Takashamisika kuona kuti intravenous administration ye 0.5 mg / kg lidocaine yakawedzera ED50 yepropofol, ichiratidza maitiro akaoma e lidocaine.
Nekuda kwekukurumidza kuita kwechiito uye nekukurumidza kupora, propofol inowanzoshandiswa sedation mukuvhiya kwevarwere.Zvisinei, madosi akakwirira epropofol akawedzera njodzi yekufema, kudonha kwemhepo yekumusoro, uye hypotension, nepo kuderera kwedosi kwakaguma nekusakwana sedation.Nokudaro, pane chido chemubatsiri anobudirira kuderedza mhinduro yekuvhiyiwa uye kuderedza kudiwa kwepropofol.Mumakore achangopfuura, zvidzidzo zvakawanda zvakaratidza migumisiro yeanalgesic ye intravenous lidocaine, kusanganisira kuderedza marwadzo mushure mejekiseni repropofol, kuderedzwa kwezvinodiwa zveopioid, uye kuderedzwa kwemarwadzo asingagumi epashure.Mune yavo yakadhindwa kubvumirana kurudziro, Foo et al.kurudzira kuti yekutanga dose isingapfuure 1.5 mg/kg yakaverengerwa uchishandisa uremu hwakakodzera hwemuviri ive yakachengeteka kune intravenous lidocaine.Munguva pfupi yapfuura, Liu et al.uye Yu et al.yakaratidza kuti intravenous administration ye lidocaine isati yaiswa anesthesia yakaguma nekuderedza ED50 yepropofol mu gastroscopy uye hysteroscopy varwere.Nokudaro, chidzidzo chedu chine chinangwa chekuedza maitiro emhando dzakasiyana-siyana dze intravenous lidocaine pane propofol-induced ED50 uye ED95 panguva yekutanga trimester uterine aspiration uye kuona iyo yakakwana dose.Isu takabvisa varwere vane nhoroondo yekuberekwa kwechikadzi uye avo vane cervical dilatation mukati memwedzi ye6 nokuti taifunga kuti varwere vane nhoroondo yekuberekwa kwechikadzi kana kuti nhoroondo yehutachiona hwehutachiona hwakanga husina kunyanya kukurudzirwa kwekervical panguva yekuvhiya kuderedzwa kupfuura varwere vasina nhoroondo yekuwedzera kwekervical dilatation.kuwedzera kwemuromo wechibereko chemurwere.28 Izvi zvinogona kutungamirira kumigumisiro yakarurama.
Intravenous lidocaine ine hafu yehupenyu hwemaminetsi mashanu-8 chete, kubva pamubhedha wevascular uye inopinda mukati memitezo yeperipheral, kutanga kuburikidza nenzvimbo dzekupfachura kwakanyanya (moyo, mapapu, chiropa, spleen), uyezve munzvimbo dze hypoperfusion.tsandanyama uye adipose tishu).10 Muchidzidzo chedu, takashandisa lidocaine isati yasvika propofol induction kuti ichengetedze plasma yayo mukati mehutano hunobudirira.Somugumisiro, kushandiswa kwe 1.5 mg / kg lidocaine pamberi pepropofol kwakaguma ne 26% kuderedzwa kweED50 yepropofol, uye 1.0 mg / kg lidocaine yakaguma nekuderedza 30%.Mhedzisiro iyi inoenderana neya Liu naXu, zvichiratidza kuti lidocaine pamadosi aya ine analgesic uye antihyperalgesic mhedzisiro.Zvinoshamisa kuti, zvisinei, iyo ED50 yakawedzerwa ne intravenous lidocaine pa 0.5 mg/kg, zvichiratidza kuti mhedzisiro ye0.5 mg/kg dose inogona kudzoserwa uye kuti yakaderera madosi eintravenous lidocaine inogona kuve yakabatana neakanyanya hypersensitivity reactions inoenderana nekutya. excitability.Lidocaine inoshanda pane akawanda mamolecular targets anobatanidzwa muacute uye asingagumi nociception, kusanganisira N-methyl-D-aspartate (NMDA) uye muscarinic cholinergic (m1, m3) receptors, iyo 100-1000 nguva inonyanya kuoma kupfuura zvimwe zvinangwa.20,29 Iyo NMDA, m1 uye m3 receptors inoramba iine hanya pane lidocaine yakadzika pasi pekiriniki yakakosha yeplasma.Lidocaine inhibisa kushandiswa kwevanhu veNMDA receptors pane nanomolar concentrations nepamusoro inhibition mu millimolar range, zvichiita kuti marwadzo asunungurwe.Lidocaine inoshanda pane muscarinic cholinergic receptors mune yekufungisisa- uye nguva-inotsamira nzira.Claes et al.yakaratidza kuti intravenous administration ye lidocaine pamadhora e10 uye 30 mg / kg yakawedzera intraspinal acetylcholine kusunungurwa uye induced central analgesia nekuita muscarinic receptors mumakonzo, asi chiyero che 1 mg / kg lidocaine haina kunyanya kuwedzera intraspinal acetylcholine kusunungurwa.30,31 Zvidzidzo zvakaratidzawo kuti lidocaine inovhara m1 uye m3 muscarinic receptors pane yakanyanya kuderera nanomolar concentrations (IC50 ye18 nM ye m1 uye 370 nM ye m3).Mukuwedzera, kuratidzwa kwenguva refu kune lidocaine pa IC50 kwakaguma ne biphasic alteration ye m1 uye m3 receptors nekutanga inhibition yakatevera maawa 8 gare gare nekuwedzera kwechiratidzo.32 Nokudaro, bolus yedu imwe chete yemishonga yakaderera zvikuru ye lidocaine 0.5 mg / kg pasina kuratidzwa kwenguva refu inogona kubudirira kunyanya kuburikidza nekudzivisa m1 uye m3 receptors.Inhibition ye m1 uye m3 receptors yainyanya kutaurwa, izvo zvinogona kutsanangura kuwedzera kweED50 muboka reL0.5 muchidzidzo chedu.Zvisinei, mukudzidza kwedu, isu hatina kuyera plasma concentration ye lidocaine.Kumwe kutsvagisa nekusimbisa kunodiwa kusimbisa fungidziro iyi.
Nhamba yehuwandu hwepropofol inodiwa pakushanda kwese yakanga yakakwirira zvikuru mumapoka eL0 neL0.5 kupfuura mune mamwe mapoka maviri.Kuwanda kwekuora mwoyo kwekufema muboka reL0.5 kwaive kwakakwirira kudarika muL0 uye L1.0 mapoka.Kuderera kweSBP mushure mekuiswa kweanesthesia muboka reL0.5 kwaive kwakakura kudarika muboka reL0.Hapana wevarwere akagadzira hypoxia, sezvatakaita kusimudza chin kana mask ventilation panguva yakakodzera.Kuwedzerwa kwehuwandu hwehuwandu hwepropofol, kuwanda kwekuora mwoyo kwekufema, uye kuderera kwe systolic blood pressure mushure mekuiswa kweanesthesia muboka reL0.5 zvakare yakaratidza kuti mazinga makuru epropofol anogona kuwedzera njodzi yekufema uye kutenderera kweropa.Pakanga pasina misiyano muzviitiko zvezviitiko zvakashata pakati pemapoka L0, L1.0 uye L1.5.Nekudaro, tichipihwa magadzirirwo echidzidzo chedu, iyo inorehwa propofol-inducing dose muboka rega rega yaive pedyo neED50 asi iri pasi peED95.Nokudaro, chiitiko chezviitiko zvakashata zvingave zvakakwirira kana varwere vari muboka reL0 vakabatwa nepropofol pamutengo weED95 (2.8 [2.6-3.2] mg / kg).Zvisinei, mhedzisiro ye lidocaine yakaguma ne ED95 ye2.0 (1.9-2.4) mg / kg uye 2.1 (1.9-2.4) mg / kg mumapoka eL1.0 uye L1.5, maererano, pamwero wakaderera.Nhaurirano iri pamusoro inotsanangura chikonzero nei tichitenda kuti analgesic effect ye intravenous lidocaine pazviyero zvakakodzera uye panguva yakakodzera inobatsira mukuderedza propofol-induced anesthesia complications.Muchidzidzo chedu, pakanga pasina misiyano yakakosha muED50, yakazara propofol dose, nguva yekumuka, uye zviitiko zvakashata pakati peL1.0 neL1.5 mapoka.Saka isu tinokurudzira dhigirii yakaderera ye1.0 mg/kg IV lidocaine seyakanyanya dhigirii.
Pane zvimwe zvinotadzisa kudzidza kwedu.Kutanga, varwere chete vane ASA I kana II vakabatanidzwa muchidzidzo ichi, asi varwere vane ASA III kana IV vanogona kunge vakanyanya kufema uye kuora mwoyo kwemwoyo pavanotora propofol.33 Uyezve, vose vatori vechikamu muchidzidzo ichi vaiva vakadzi vane pamuviri, uye zvigumisiro zvingave zvine chokuita nekusiyana kwehupenyu, kusiyana kwehuwandu hwevarume.Chechipiri, isu tinoshandisa iyo MOAA/S mamakisi sechiratidzo cheyero yekunyaradza kwete yezvinangwa zvakaita sekutarisa kweBIS.34 Chechitatu, lidocaine yaishandiswa se bolus imwe chete uye hatina kuyera mazinga eplasma e lidocaine.Chekupedzisira, ED95 inotemerwa neED50, saka kumwe kutsvagurudza kunodiwa kuti uwane data rakawanda.
Migumisiro yechidzidzo chedu chemazuva ano yakaratidza kuti intravenous administration ye 1.0 mg/kg lidocaine isati yasvika propofol jekiseni yakaderedza zvakanyanya ED50, ED95, uye yakazara propofol dose muvarwere vari kutanga-trimester ambulatory hysteroscopy pasi peanesthesia, yakaenzana nehuwandu hunobudirira hwe1.5 mg / kg.Isu tinoona muyero we1.0 mg/kg kuti ive yakanyanya kurongeka.Zvinoshamisa kuti intravenous dose ye 0.5 mg / kg lidocaine yakawedzera ED50 yepropofol, ichiratidza maitiro akaoma e lidocaine.Zvimwe zvidzidzo zvezvirongwa zvepasi zvinodiwa kuti tisimbise mhedzisiro yedu.
Iyo data yakawanikwa panguva yekudzidza inogona kuwanikwa kubva kumunyori anowirirana (Ni Huang).
Ndinoda kuonga Dr. Huang Han kubva kudhipatimendi redu uye vanamukoti vari muimba yekushanda nekuda kwekutsigira kwavo kwakasimba.
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