叶平安、朱银南著《实用麻醉药理学》(1995年,第1版,陕西科学技术出版社)内容丰富,获益匪浅。现仅就其中利多卡因静滴剂量提出质疑。该书中第137页倒第7行论及“象普鲁卡因、利多卡因等局麻药,经静脉缓慢滴注,常可引起镇静、痛阈升高,故被用作静脉复合麻醉。当然,这是在小剂量应用(普鲁卡因1mg·kg~(-1)min~(-1)或利多卡因0.2～0.5mg·kg~(-1)·min~(-1))时,以及在应用巴比妥类或安定麻醉诱导下进行的。即使吸收量稍微大些,也会迅速地被酶水解,不至于蓄积或逾量中毒。”笔者还注意到叶平安教授在《应用麻醉学》中,论及利多卡因作静脉全麻时小剂量是每分钟0.5mg·kg~(-1)。现仅就有关问题与作者商榷。由于利多卡因中毒反应发生率比普鲁卡因高,且来势凶猛,如不及时处理,可迅速发展为呼吸、心跳停止,故临床应用剂量有严格限制。用于神经阻滞,一次 Ye Pingan, Zhu Yinan “Practical anesthesiology pharmacology” (1995, first edition, Shaanxi Science and Technology Press) rich in content, benefit a lot. It is only one of the lidocaine intravenous dose questioned. The seventh page of the book, p. 137, deals with “local anesthetics such as procaine and lidocaine. Slow intravenous drip usually causes sedation and increased pain threshold, so it is used as intravenous anesthesia Of course, this is in low dose application (procaine 1mg · kg -1 min -1 or lidocaine 0.2-0.5 mg · kg -1 min -1) ), As well as induction by anesthesia with barbiturates or diazepam, even if the absorption is slightly larger, it is quickly hydrolyzed by enzymes without accumulation or overdosing. ”The author also notes that Professor Ye Pingan In “Applied Anesthesiology”, the low dose of lidocaine for intravenous general anesthesia is 0.5 mg · kg -1 per minute. Discuss with the author only on the relevant issues. Due to the incidence of lidocaine poisoning than procaine, and ferocious, if not promptly treated, can quickly develop into breathing, cardiac arrest, so the clinical application of the dose is strictly limited. For nerve block, once