中/长链脂肪乳和利多卡因对丙泊酚注射痛的影响

目的观察丙泊酚中/长链脂肪乳、传统丙泊酚单独用药或混合利多卡因对注射痛的影响。方法新疆医科大学附属中医医院2010年2-6月行无痛人流术患者160例,年龄18～40岁,ASA分级Ⅰ或Ⅱ级。采用随机、双盲对照方法,将患者随机分为丙泊酚组(A组)、丙泊酚+利多卡因组(B组)、丙泊酚中/长链脂肪乳组(C组)和丙泊酚中/长链脂肪乳+利多卡因组(D组)4组。麻醉前不用术前药,麻醉诱导采用微量泵恒速静脉给药,4组输注时间均为60s,从开始输注丙泊酚时询问患者注射部位感觉,观察患者有无皱眉、流泪和手臂躲避抽动等行为。根据患者主诉和行为反应进行注射痛的口述描绘(VRS)评分。结果 4组患者出现重度注射痛的发生率分别是A组25.0%、B组12.5%、C组10.0%和D组5.0%,A组与B组、C组和D组相比较,差异有统计学意义(P<0.05),B组和D组比较差异有统计学意义(P<0.05);4组无注射痛的发生率分别是A组25.0%、B组67.5%、C组62.5%和D组70.0%,B组、C组和D组与A组比较,差异有统计学意义(P<0.05),B组、C组和D组比较差异无统计学意义(P>0.05)。结论中/长链脂肪乳和利多卡因均能显著降低丙泊酚注射痛,患者有较好的耐受性,但以丙泊酚中/长链脂肪乳复合利多卡因效果最优。

Influence of medium/long chain triglycerides and lidocaine on propofol injection pain

Objective To investigate the incidence of injection pain during administration of propofol emulsion of long-chain triglyceride(LCT) and propofol emulsion of medium-chain and long-chain triglycerides(MCT/LCT) with or without premixed lidocaine in patients.Methods One hundred and sixty patients,with ASA Ⅰ or Ⅱ,aged 18-40 years,which came from Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University,they were received painless induced abortion.With a randomized,double blind trial,all patients were divided into 4 groups with 40 cases each.Patients were divide into propofol group(group A),propofol+lidocaine group(group B),propofol(MCT/LCT) group(group C) and propofol(MCT/LCT) with lidocaine group(group D).Patients in groups A received propofol LCT(2 mg/kg),patients in group B received propofol LCT(2 mg/kg) with lidocaine(40 mg),patients in group C received propofol(MCT/LCT)(2 mg/kg),and patients in group D received propofol(MCT/LCT)(2 mg/kg) with lidocaine(40 mg).Any druges were given proanethesia.Propofol were given by trace pumps in constant speed in 60 s by dorsal venous of hand.The incidence and intensity of injection pain was assessed by verbal rating scale(VRS).Results The percent of severe pain patients in each group were 25%,12.5%,10% and 5%,respectively.The percent of severe pain patients in group A was significant difference between group B,C and D(P<0.05).The percent of no pain patients in each group were 25%,67.5%,62.5% and 70.0% respectively.The percent of s no pain patients in group A was significant difference between group B,C and D(P<0.05).Conclusion Propofol MCT/LCT and lidocaine can decrease the percent of injection pain obviously,petients can acquire better tolerance,but effect of combination is best than alone.