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경막외 Lidocaine의 최대사용량과 혈중농도에 대한 고찰
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  • 경막외 Lidocaine의 최대사용량과 혈중농도에 대한 고찰
저자명
박한석,정찬종,진영준,Park. Han-Suk,Chung. Chan-Jong,Chin. Young-Jhoon
간행물명
大韓痛症學會誌
권/호정보
1999년|12권 1호|pp.36-42 (7 pages)
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이 논문은 한국과학기술정보연구원과 논문 연계를 통해 무료로 제공되는 원문입니다.
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기타언어초록

Background: The current maximal recommended doses of lidocaine are 7 mg/kg with $5;{mu}g/ml$ of epinephrine. But in clinical practice, sometimes more doses of lidocaine are required to produce adequate regional anesthesia. Method: Twenty-two healthy women patients were divided into two groups and pretreated with valium 5 mg p.o., morphine 5 mg i.m., and midazolam 2 mg i.v. before operation. Of these, 7 mg/kg of 2% lidocaine with $5;{mu}g/ml$ of epinephrine were given to 11 patients epidurally. Initial 3 ml of epinephrine mixed lidocaine was given as a test dose and remaining doses were given 5 ml/30 sec with 3 min intervals. Radial arterial blood were drawn at 5, 10, 15, 20, 30, 45, 60, 90, 120 min to measure plasma lidocaine concentrations. After confirming all of the peak plasma concentrations of 7 mg/kg lidocaine were absolutely under $5;{mu}g/ml$, the other 11 patients were given 10 mg/kg of 2% lidocaine with $5;{mu}g/ml$ of epinephrine epidurally and blood samplings were taken according to the same method of 7 mg/kg group. The peak plasma concentration ($C_{max}$), time to reach to $C_{max}$ ($T_{max}$), time to reach to $T_4$, maximal sensory block level, systemic toxicity, and vital sign changes were investigated. Result: $C_{max}$ was significantly higher in 10 mg/kg group ($5.1{pm}1.3;{mu}g/ml$) than 7 mg/kg group($3.3{pm}0.5;{mu}g/ml$), but $T_{max}$ ($10.5{pm}2.7$ min vs $10.9{pm}3.1$ min) was not different. Time to reach $T_4$ was significantly shorter in 10 mg/kg group ($9.5{pm}2.7$ min) than 7 mg/kg group ($12.7{pm}3.2$ min) but maximal sensory block level ($T_{3.7{pm}0.7}$ vs $T_{2.7{pm}1.0}$) was not different. In four patients of 10 mg/kg group, peak plasma concentrations exceeded $5;{mu}g/ml$, but no systemic toxicities appeared. No significant vital sign changes were observed. Conclusion: The current maximal recommended doses of lidocaine, merely based on body weight are not always appropriate. Further studies are needed to determine more precise guideline of maximal doses that include various pharmacokinetic components.