利多卡因、芬太尼和布托啡诺分别用于预防丙泊酚注射痛的疗效观察

目的观察预给利多卡因、芬太尼或布托啡诺预防丙泊酚注射痛的效果。方法采用双盲法,选择符合标准择期手术病人160例,随机分为A组（布托啡诺组）、B组（利多卡因组）、C组（芬太尼组）和D组（对照组）,每组40例。麻醉诱导前1min,四组病人分别静脉注射布托啡诺1mg（2mL）、利多卡因40mg（2mL）、芬太尼0.05mg（2mL）或生理盐水2mL。然后,所有病人以每秒0.5mL速度缓慢静脉注射丙泊酚100mg,从预给药开始由另外一名麻醉医生观察是否发生注射痛及严重程度。结果与对照组比较,利多卡因组和布托啡诺组注射痛发生率和严重程度明显降低（P〈0.05）,芬太尼组注射痛发生率降低但无统计学意义,严重程度明显降低（P〈0.05）,各试验组效果：布托啡诺组≈利多卡因组〉t;芬太尼组。结论预给布托啡诺或利多卡因均可有效减少和减轻丙泊酚注射痛,但预给芬太尼不能有效减少疼痛发生率只能减轻疼痛程度。

Pain during injection of propofol:the effect of pretreatments of fentanyl,lidocaine,or butorphanol

OBJECTIVE To compare the effect of pretreatment with fentanyl, lidocaine, or butorphanol for prevention of pain associated with propofol injection. METHODS This study was conducted in a randomized double-blind fashion. 160 adult patients undergoing elective surgical procedures without difficulty in communication were divided into four groups randomly： Group A （Ⅳ butorphanol 1mg, n = 40）, Group B （Ⅳ 2% lidocaine 40mg, n = 40）, Group C （ Ⅳfentanyl 0.05mg, n = 40）, Group D （Ⅳ normal saline 2mL, n = 40 ; as placebo control）. All patients received pretreatment solutions（butorphanol lmg, 2% lidocaine 40 mg, fentanyl 0.05mg, normal saline） 1 min before induction of anesthesia with propofol depending on the group to which they belonged. Patients then received 100 mg propofol at the rate of 0.5 mL/s. Patients were continuously observed the incidence and severity of pain associated with Ⅳ injection of propofol. RESULTS Butorphanol and Lidocaine sig-nificantly reduced propofol injection pain more than placebo （P 〈 0.05）. Fentanyl reduced the intensity of propofol injection pain （P 〈 0.05） and had some effect in reducing the incidence of propofol injection pain, but the di ference did not reach statistical significance. The order of efficacy was butorphanol ≈lidocaine 〉 fentanyl.CONCLUSlON Pretreatments with lidocaine or butorphanol is effective in reducing propofol injection pain, whereas fentanyl only slightly reduced the propofol injection pain.