艾司洛尔预处理对丙泊酚注射痛的影响

目的：观察小剂量艾司洛尔预处理对丙泊酚静脉注射痛的影响。方法：美国麻醉医师协会（ASA）分级为Ⅰ～Ⅱ级且择期行全麻手术的患者120例,随机分为3组,每组40例。经左前臂桡侧浅静脉置入20G套管留置针。麻醉诱导前左上臂包裹气压止血带,加压至70mmHg后,按分组以3mL/10s速度分别静脉注射：0.9%氯化钠液3mL（C组）,利多卡因0.5mg/kg（L组）,艾司洛尔0.25mg/kg（E组）,60s后松开止血带,将2mg/kg丙泊酚在20s内缓慢注入。随后静脉注射芬太尼、维库溴胺,行气管插管全麻。采用4分制记录3组患者丙泊酚注射痛评分,并记录药物预注前（T0）、气管插管前（T1）、气管插管后1min（T2）、气管插管后3min（T3）的平均动脉压（MAP）和心率（HR）。结果：注射痛的发生率C组为65%（26/40）,而L组为10%（4/40）,E组为25%（10/40）,与C组相比显著降低（P〈0.01）。L组和E组中度和重度疼痛的发生率均显著低于C组（P〈0.05和P〈0.01）。E组与L组比较,差异无统计学意义（P〉0.05）。结论：小剂量艾司洛尔预处理合用止血带可有效缓解丙泊酚注射痛。

Effect of Pretreatment with Esmolol on Propofol Injection Pain

Objective：To investigate the effect of pretreatment with low-dose esmolol on propofol injection pain.Methods：One hundred and twenty ASA Ⅰ-Ⅱ patients,undergoing general anesthesia,were randomly allocated into three groups（40 patients each）.A 20-gauge catheter was inserted into a superficial radial vein of the left hand,and after the occlusion of venous drainage using a pneumatic tourniquet applied to the left upper arm（70 mmHg）,Group C,Group L and Group E were pretreated with 3 mL of normal saline,lidocaine 0.5 mg/kg,and esmolol 0.25 mg/kg in 10s,respectively.The occlusion was released after 60s and propofol 2 mg/kg was injected into the vein in 20s.During the injection of propofol,patients＇ pain was assessed and recorded as 0-3,corresponding to no,mild,moderate or severe pain,respectively.And induction of anesthesia continued with intravenous fentanyl 3 μg/kg and vecuronium 0.1mg/kg to facilitate tracheal intubation.mean arterial pressure（MAP） and heart rate（HR） were recorded before pretreatment（T0）,before tracheal intubation（T1）,1 min（T2） and 3 min（T3） after tracheal intubation,respectively.Results：The incidence of pain in Group L（10%） and Group E（25%） was significantly lower than that in Group C（65%）（P0.01）.The incidence of moderate and severe pain in Group L and Group E was also significantly lower than that in Group C（P0.01 and P0.05,respectively）.Conclusions：Pretreatment with intravenous low-dose esmolol combined with occlusion of venous drainage seems to be effective to attenuating pain during intravenous injection of propofol.