目的 探讨利多卡因对面神经微血管减压术后镇痛作用。方法 选择80例择期面神经减压手术患者, 随机分成利多卡因组和对照组, 利多卡因组诱导前给予利多卡因1.5 mg/kg, 续以2 mg/(kg·h) 持续泵注, 对照组给予等量的生理盐水。所有患者均接受静脉全身麻醉, 术毕给予芬太尼自控静脉镇痛(patient controlled intravenous analgesia, PCIA), 观察术后2、4、6、12、24 h的VAS评分, 记录不良反应。结果 术后各个时间点, 利多卡因组的VAS评分均低于对照组（P＜0.05）。对照组24 h内追加芬太尼的用量高于利多卡因组［(512±42.5) μg vs (446±30.6) μg , P＜0.05］。对照组恶心呕吐发生率高于利多卡因组（P＜0.05）。结论 静脉应用利多卡因能够协同芬太尼术后镇痛作用, 不良反应轻。

Objective To study the analgesic effect of intravenous lidocaine on postoperative pain of microvascular decompression. Methods Eighty patients scheduled for microvascular decompression were randomized into two groups, who either received placebo or lidocaine 1.5 mg/kg bolus before the induction of anesthesia followed by 2 mg/（kg·h）continuous IV. The patients underwent general anesthesia and postoperative pain was freated with patient-controlled IV fentanyl analgesia. The visual analog scale scores for pain and side effects were recorded at 2, 4, 6, 12, and 24 hours after surgery. Results The visual analog scale scores for pain at 2, 4, 6, 12, and 24 hours were lower in the lidocaine group than those in the placebo group（P<0.05）. The total dose of fentanyl (0-24 h after surgery) was lower in the lidocaine group than that in the placebo group（P<0.05）. The incidence of nausea and vomiting was smaller in the lidocaine group than that in the placebo group（P<0.05）. Conclusions Ⅳ lidocaine in microvascular decompression can reduce the fentanyl consumption and incidence of nausea and vomiting, which is a useful multimodal analgesic method.