Effect of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecological laparoscopic surgery

LI Sheng-yong; LI Wen; CUI Xiao-guang

doi:10.11659/jjssx.03E025079

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Effect of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecological laparoscopic surgery

Clinical Research | 更新时间：2025-12-22

- Effect of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecological laparoscopic surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 12, Pages: 1102-1106(2025)
- 作者机构：
  
  海南医科大学第一附属医院麻醉科，海南海口 570102
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E025079
  CLC： R614
- Received：14 March 2025，
  
  Published：25 December 2025
- 稿件说明：
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李笙永,李文,崔晓光.静脉输注利多卡因对妇科腹腔镜手术患者颅内压的影响[J].局解手术学杂志,2025,34(12):1102-1106.

LI Sheng-yong,LI Wen,CUI Xiao-guang.Effect of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecological laparoscopic surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1102-1106.
李笙永,李文,崔晓光.静脉输注利多卡因对妇科腹腔镜手术患者颅内压的影响[J].局解手术学杂志,2025,34(12):1102-1106. DOI： 10.11659/jjssx.03E025079.

LI Sheng-yong,LI Wen,CUI Xiao-guang.Effect of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecological laparoscopic surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(12):1102-1106. DOI： 10.11659/jjssx.03E025079.

摘要

目的

探讨静脉输注利多卡因对妇科腹腔镜手术患者颅内压的影响及其适宜剂量。

方法

选取2024年9月至12月于我院择期行妇科腹腔镜手术的患者119例，采用随机数字表法将患者分为C组（30例）、L1组（30例）、L2组（30例）、L3组（29例）。L1、L2、L3组患者在麻醉诱导时分别静脉注射利多卡因0.5 mg/kg、1.0 mg/kg、1.5 mg/kg，继而分别以0.5 mg·kg

-1

·h

-1

、1.0 mg·kg

-1

·h

-1

、1.5 mg·kg

-1

·h

-1

的速率进行维持；C组患者则以等量生理盐水进行静脉注射和麻醉维持。比较4组患者麻醉诱导前（T0），平卧位气管插管后5 min（T1），CO

气腹结合头低足高位后5 min（T2）、30 min（T3）、60 min（T4），关闭气腹恢复平卧位后5 min（T5）时的视神经鞘直径（ONSD）与眼球横径（ETD）的比值、心率（HR）、平均动脉压（MAP）。比较4组患者术中和麻醉恢复室（PACU）期间不良反应发生率、血管活性药物使用情况、苏醒和拔管时间。

结果

与C组比较，L2组患者T2~T4时ONSD/ETD值显著降低（

0.05），L3组患者T2~T5时ONSD/ETD值显著降低（

0.05）。L3组患者T4时ONSD/ETD值显著低于L2组（

0.05）。L2组患者T2~T5时HR低于C组（

0.05），L3组患者T1~T5时HR显著低于C组及L2组（

0.05）。L1组与L2组患者T5时MAP均显著低于C组（

0.05），L3组患者T1~T5时MAP显著低于C组（

0.05），L3组患者在T2、T3时MAP显著低于L2组（

0.05）。4组患者术中及PACU期间总体不良反应发生率、苏醒时间、拔管时间比较，差异均无统计学意义（

0.05）。

结论

静脉输注利多卡因可以缓解妇科腹腔镜手术期间患者颅内压升高，且其推荐剂量为诱导期1.5 mg/kg的利多卡因静脉推注，术中以1.5 mg·kg

-1

·h

-1

速率维持。

Abstract

Objective

To investigate the effect and appropriate dose of intravenous lidocaine infusion on intracranial pressure of patients undergoing gynecologic laparoscopic surgery.

Methods

A total of 119 patients who underwent elective gynecologic laparoscopic surgery in our hospital from September to December 2024 were selected and divided into group C （30 cases），group L1 （30 cases），group L2 （30 cases），and group L3 （29 cases） by the random number table method. Patients in group L1， group L2，and group L3 were given intravenous lidocaine 0.5 mg/kg，1.0 mg/kg，and 1.5 mg/kg du

ring anesthesia induction，followed by maintenance infusion at the rates of 0.5 mg·kg

-1

·h

-1

，1.0 mg·kg

-1

·h

-1

，and 1.5 mg·kg

-1

·h

-1

，respectively. Patients in group C were given an equal amount of saline for intravenous injection and anesthesia maintenance. The ratio of optic nerve sheath diameter （ONSD） to eyeball transverse diameter （ETD），heart rate （HR），and mean arterial pressure （MAP） before anesthesia induction （T0），5 minutes after supine tracheal intubation （T1），5 minutes （T2），30 minutes （T3），and 60 minutes （T4） after CO

pneumoperitoneum combined with Trendelenburg positioning， and 5 minutes after restoring supine position with pneumoperitoneum release （T5） were compared among the four groups of patients. The incidence of adverse reactions during intraoperative and post-anesthesia care unit （PACU） periods，use of vasoactive drugs， awakening time and extubation time were compared among the four groups of patients.

Results

Compared with group C，the ONSD/ETD values in group L2 at T2 to T4 were significantly decreased （

0.05）， and the ONSD/ETD values in group L3 at T2 to T5 were significantly decreased （

0.05）. The ONSD/ETD value in group L3 at T4 was significantly lower than that in group L2 （

0.05）. The HRs in group L2 at T2 to T5 were significantly lower than those in group C （

0.05）； The HRs in group L3 at T1 to T5 were significantly lower than those in group C and group L2 （

0.05）. The MAPs in both group L1 and group L2 at T5 were significantly lower than that in group C （

0.05）； The MAPs in group L3 at T1 to T5 were significantly lower than those in group C （

0.05），and the MAPs in group L3 at T2 and T3 were significantly lower than those in group L2 （

0.05）. There was no statistically significant difference in the overall incidence of adver

se reactions during intraoperative and PACU periods， awakening time，or extubation time among the four groups of patients（

0.05）.

Conclusion

Intravenous lidocaine infusion can alleviate the increased intracranial pressure of patients during gynecological laparoscopic surgery.The recommended dosage of lidocaine is an intravenous injection of 1.5 mg/kg during the induction phase，followed by a continuous intraoperative maintenance infusion at 1.5 mg·kg⁻¹·h⁻¹.

关键词

Keywords

references

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