静脉注射利多卡因
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Intravenous lidocaine
背景与目的
利多卡因具有镇痛、抗痛觉过敏、消炎等不同作用，这使得其作为一种常用的麻醉性辅助药。利多卡因能够减轻外科手术中应激反应引起的痛觉感受及心血管反应，也可以降低围术期疼痛及镇痛需要。然而，利多卡因的作用机理尚不清楚，尽管已经明确其不同属性。
方 法
通过检索阅读并分析早期到最新的有关文献，如荟萃分析、亚组分析等，并结合临床随机试验，从而得到有关结果与结论。
结 果
围术期利多卡因静脉注射推荐剂量为：小剂量（1-2 mg/kg）使用利多卡因后，持续输注剂量（1-2mg/kg/h）。无论对围术期疼痛、慢性疼痛，还是与硬膜外镇痛相比较，静脉注射利多卡因都有十分明显的效果。无论从药效学、药动学，还是毒性反应方面，静脉注射利多卡因都十分安全。
结 论
尽管利多卡因的具体作用机理目前尚未完全解释清楚。小剂量使用利多卡因后持续输注有明显的镇痛效果。利多卡因可作为减少或替代阿片类药物麻醉的主要药物之一，它明显地改善并增加了围术期病人的满意度。这样的手段常常用于术后快速康复治疗（ERAS）。据有关推荐指南，利多卡因的安全性如其有效性一样可靠。
原始文献摘要
Estebe J-P；Best Practice & Research Clinical Anaesthesiology (2017) doi, 10.1016/j.bpa.2017.05.005； Intravenous lidocaine；
Abstract:Lidocaine has analgesic effect, anti-hyperalgesic and anti-inflammatory properties, which makes it use as a general anesthetic adjuvant. Lidocaine is capable of reducing nociception and/or cardiovascular responses to the surgical stress, and postoperative pain and/or analgesic requirements. However, its mechanisms of action remain unclear, despite its different known properties. If the exact mechanism of action remains not fully explained; bolus then continuous lidocaine infusion has clear analgesic benefits. Lidocaine is one of major drug for opioid reduced anesthesia (ORA) or opioid free anesthesia (OFA) procedures. It clearly improves the postoperative outcomes with increased patient satisfaction. Such procedure takes place wisely in the enhanced recovery after surgery (ERAS) protocols. With recommended protocols, safety will be as great as his efficacy
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