[1]乔国艳,林显文,叶源才,等.利多卡因联合硫酸镁静脉泵注治疗顽固性三叉神经痛20例临床研究*[J].陕西医学杂志,2020,49(10):1337-1239，1243.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.009]
　QIAO Guoyan,LIN Xianwen,YE Yuancai,et al.Intravenous infusion lidocaine and magnesium sulphuricum for management of intractable trigeminal neuralgia:a case series of 20 patients and evidence review[J].,2020,49(10):1337-1239，1243.[doi:DOI:10.3969/j.issn.1000-7377.2020.10.009]
点击复制

利多卡因联合硫酸镁静脉泵注治疗顽固性三叉神经痛20例临床研究*
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年10期
页码:
1337-1239，1243
栏目:
临床研究
出版日期:
2020-10-05

文章信息/Info

Title:
Intravenous infusion lidocaine and magnesium sulphuricum for management of intractable trigeminal neuralgia:a case series of 20 patients and evidence review
作者:
乔国艳1; 林显文1; 叶源才2; 梁 鹏2△
1.成都市成飞医院内科(成都610091); 2.四川大学华西医院麻醉手术中心(成都610041)
Author(s):
QIAO Guoyan; LIN Xianwen; YE Yuancai; et al.
Department of Internal Medicine,Chengfei Hospital,Chengdu(Chengdu 610091)
关键词:
三叉神经痛;  硫酸镁;  利多卡因;  神经病理性疼痛;  抑郁;  焦虑
Keywords:
Trigeminal neuralgia;  Magnesium sulphuricum;  Lidocaine;  Neuropathic pain;  Depression;  Anxiety
分类号:
R745.1
DOI:
DOI:10.3969/j.issn.1000-7377.2020.10.009
文献标志码:
A
摘要:
目的:探讨使用利多卡因联合硫酸镁静脉泵注治疗神经病理性疼痛的方法,提高顽固性三叉神经痛的治疗效果。方法: 对治疗神经病理性疼痛常规用药治疗方案不佳的20例顽固性三叉神经痛患者,维持原有药物治疗的基础上,使用利多卡因100 mg/kg复合硫酸镁1.25 g,1 h静脉泵注完,1次/周,共计3周方案,观察治疗前后使用视觉模拟评分(VAS),抑郁自评量表(SDS)及焦虑自评量表(SAS)评估患者疼痛及抑郁焦虑评分的变化。结果:一共治疗顽固性三叉神经痛患者20 例,所有患者在接受3个疗程的治疗后,疼痛均得到不同程度缓解,治疗前后比较差异有统计学意义(P<0.05),2例患者曾出现一过性头昏乏力,无抽搐等局麻药中毒反应及其他严重不良反应; 所有20例患者治疗前后焦虑抑郁评分均高于全国常模,且差异有统计学意义(P<0.05),治疗后焦虑抑郁评分较治疗前有所下降,但差异无统计学意义(P>0.05)。 结论:利多卡因联合硫酸镁静脉泵注射治疗顽固性三叉神经痛取得良好的治疗效果,且无严重不良反应。
Abstract:
Objective:To explore the method of lidocaine combined with magnesium sulfate intravenous infusion in the treatment of neuropathic pain and improve the therapeutic effect of intractable trigeminal neuralgia.Methods:We used a novel protocol to treat 20 patients for management of intractable neuropathic pain with severe TN by using an intravenous infusion of a combination of 100 mg/kg lidocaine and 1.25 g magnesium sulphuricum for 1 hour,once a week for 3 weeks.The scores of pain,depression and anxiety were evaluated before and after therapy by VAS,SDS and SAS.Results:All patients experienced sound pain relief after the combined intravenous infusion therapy(P<0.05).Two patients experienced short and mild dizziness after the therapy,but no severe side effects were reported.The scores of depression and anxiety of all patients were higher than norm(P<0.05).The scores of anxiety and depression decreased after therapy,but the difference was not statistically significant(P>0.05).Conclusion:Intravenous magnesium sulphuricum and lidocaine is an effective and safe supplement method for management of intractable trigeminal neuralgia patients.

参考文献/References:

[1] International Headache Society.The International classification of headache disorders:2nd edn [J].Cephalalgia,2004,24(Suppl 1):9-16.
[2] Obermann M.Treatment options in trigeminal neuralgia[J].Ther Adv Neurol Disord,2010(3):107-115.
[3] 郭玉涛,屈建强.微血管减压术治疗三叉神经痛的临床疗效分析[J].陕西医学杂志,2018,47(6):983-984.
[4] 王建峰,孟喜君,李晓怡.伽玛刀治疗三叉神经痛201例长期疗效观察[J].陕西医学杂志,2015,44(1):27-28.
[5] Prisco L,Ganau M,Bigotto F,et al.Trigeminal neuralgia:successful antiepileptic drug combination therapy in three refractory cases [J].Drug Healthc Patient Saf,2011(3):43-45.
[6] Pollock BE.Surgical management of medically refractory trigeminal neuralgia [J].Curr Neurol Neurosci Rep,2012(12):125-131.
[7] Huang CF,Chuang JC,Tu HT,et al.Microsurgical outcomes after failed repeated Gamma Knife surgery for refractory trigeminal neuralgia [J].J Neurosurg,2006,105(Suppl):117-119.
[8] Abdi S,Lee DH,Chung JM.The anti-allodynic effects of amitriptyline,gabapentin,and lidocaine in a rat model of neuropathic pain [J].Anesth Analg,1998(87):1360-1366.
[9] Lauretti GR.Mechanisms of analgesia of intravenous lidocaine [J].Rev Bras Anestesiol,2008(58):280-286.
[10] Mc Cleane G.Intravenous lidocaine:an outdated or underutilized treatment for pain?[J].J Palliat Med,2007(10):798-805.
[11] Cahana A,Carota A,Montadon ML,et al.The long-term effect of repeated intravenous lidocaine on central pain and possible correlation in positron emission tomography measurements [J].Anesth Analg,2004(98):1581-1584.
[12] 张明圆.精神科评定量表手册[M].长沙:湖南科学技术出版社,1998:35-42.
[13] 郜锦英,刘娟丽,程 宏,等.普瑞巴林对PDPN患者正中神经、腓总神经传导速度及疼痛改善效果研究[J].陕西医学杂志,2018,47(4):515-517.
[14] Schwartzman RJ,Patel M,Grothusen JR,et al.Efficacy of 5-day continuous lidocaine infusion for the treatment of refractory complex regional pain syndrome [J].Pain Med,2009(10):401-412.
[15] Mony L,Kew JN,Gunthorpe MJ,et al.Allosteric modulators of NR2B-containing NMDA receptors:molecular mechanisms and therapeutic potential [J].Br J Pharmaco,2009(157):1301-317.

相似文献/References:

[1]陈园园,王利平.叶酸、维生素E联合硫酸镁治疗妊娠期高血压疗效及对患者血管内皮功能、Th1/Th2细胞水平的影响[J].陕西医学杂志,2021,50(2):208.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.021]
　CHEN Yuanyuan,WANG Liping.Efficacy of folic acid,vitamin E combined with magnesium sulfate in treatment of gestational hypertension and its effect on vascular endothelial function and Th1/Th2 cell level[J].,2021,50(10):208.[doi:DOI:10.3969/j.issn.1000-7377.2021.02.021]
[2]马立茵,李 静.沙丁胺醇治疗重度哮喘急性发作疗效及对患儿血清TOLL样受体4、核转录因子κB通路的影响[J].陕西医学杂志,2022,51(2):230.[doi:DOI:10.3969/j.issn.1000-7377.2022.02.024]
[3]张 娇,周 茜,李 萌,等.显微血管减压术、经颅电刺激以及球囊压迫术治疗三叉神经痛临床对比研究[J].陕西医学杂志,2023,52(4):414.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.011]
　ZHANG Jiao,ZHOU Qian,LI Meng,et al.Clinical study of microvascular decompression,transcranial electrical stimulation and balloon compression in treatment of trigeminal neuralgia[J].,2023,52(10):414.[doi:DOI:10.3969/j.issn.1000-7377.2023.04.011]

备注/Memo

备注/Memo:
*国家自然科学基金资助项目(81600918)
更新日期/Last Update: 2020-10-10