目的：探讨静脉持续输注利多卡因对全身麻醉下止血带相关高血压（TIH）的影响。方法：选择我院日间行膝关节镜手术ASAⅠ或Ⅱ级的患者40名，随机分为两组：对照组（C组）和利多卡因组（L组）。L组在诱导插喉罩后给予利多卡因负荷量1.0mg/kg，持续泵注15min，之后以1.0mg/kg/h持续泵注至手术结束，C组给同等剂量生理盐水泵注处理。观察入室( T0 ) 、诱导后5 min ( T1 ) 、止血带充气时（T2）、充气30min( T3 ) 、充气 45min( T4) 、充气60min（T5）、放气前( T6 ) 、放气后 20min( T7) 的 HR、SBP、DBP；记录术中止血带相关高血压及降压药使用情况；记录术后1、3、6、24 和 48 h静息 VAS 评分，记录围术期不良反应发生情况。结果：两组内不同时间点检测的血流动力学差异具有统计学差异（P <0.001）。T3、T4、T5、T6时，L组的血压比C组低（P <0.05）。T4、T5时，L组心率比C组低（P <0.05）。T3、T4时，L组TIH发生率比C组低（P=0.008；P=0.011）。与C组相比，L组术后1h、3h、6h时静息时 VAS 评分低（P=0.023；P=0.025；P=0.03）。其他时间点两组的差异无统计学差异。结论：在应用止血带的膝关节镜手术中，静脉持续输注利多卡因可有效降低TIH的发生，改善患者术后镇痛。
Objective: To investigate the effect of intravenous lidocaine on tourniquet-related hypertension (TIH) under general anesthesia. Methods: We selected 40 patients with ASA I or II grade undergoing ambulatory knee arthroscopy surgery in our hospital. The patients were divided into two groups randomly : the control group (group C) and the lidocaine group (group L). Patients in the lidocaine group were given a load of 1.0 mg/kg for 15 minutes after induction and then maintained at 1.0 mg/kg/h until the end of the operation. The control group was treated with the same volume of saline . Index including HR, SBP, DBP, MAP were observed at these times：after entering the room (T0 ), 5 min after induction (T1 ), the time when tourniquet is inflated (T2), 30 min after tourniquet is inflated (T3 ), 45 min after tourniquet is inflated (T4 ), 60 min after tourniquet is inflated (T5 ), before deflation (T6 ), 20 min after tourniquet is deflated (T7); Recording the occurrence of tourniquet-related hypertension (TIH) and the use of antihypertensive drugs; Recording the resting VAS scores at 1, 3, 6, 24, and 48 hours after surgery; Recording the occurrence of adverse reactions such as local anesthetic poisoning.Results: In the C group and the L group, the differences in hemodynamics measured at different time points are statistically different (P<0.001). Compared to these at T2, blood pressure and heart rate at T3, T4, T5, and T6 showed an upward trend. At T3, T4, T5, and T6, BP in the L group was lower than that in the C group (all P<0.05). At T4 and T5, HR of the L group was lower than that in the C group. At T3 and T4, the incidence of TIH in the L group was lower than that in C group (P=0.008; P=0.011). Compared to the C group, the L group had lower VAS scores at 1h, 3h, and 6h after surgery (P=0.023; P=0.025; P=0.03). There was no statistical difference between the two groups at other time points. Conclusion: In knee arthroscopic surgery using tourniquets, low-dose intravenous lidocaine can effectively prevent tourniquet-related hypertension (TIH) and improve the quality of postoperative rehabilitation.