静脉注射亚甲蓝缓解丙泊酚注射痛的临床研究

目的:评估静脉注射亚甲蓝降低丙泊酚注射痛的有效性和安全性。方法:180例择期行无痛胃镜检查患者,年龄18~50岁,ASA分级Ⅰ~Ⅱ级,随机分为3组:M组和L组均为实验组,C组对照组,每组60例。注射丙泊酚前行预处理,M组和L组分别静脉注射亚甲蓝20 mg和2%利多卡因40 mg。C组注射同容量生理盐水。0.5 m L/s静脉注射1%丙泊酚进行麻醉诱导,直到患者意识消失。注射时,用Ambesh四分法评估注射痛发生率和严重程度。1 d后电话随访,询问患者是否有不良反应。结果:共178例完成并纳入研究。C组注射痛发生率高达91.5%,明显高于两实验组(P<0.017);M组和L组疼痛发生率分别为40.0%和27.1%,两实验组间比较无统计学意义。C组以中、重度疼痛为主,两实验组则以轻中度疼痛为主。次日电话随访,除两2例患者拒绝外,其余均未出现不良反应。结论:亚甲蓝可替代利多卡因静脉注射,有效缓解丙泊酚注射痛。

Clinical research of intravenous administration of methylene blue reducing the pain associated with propofol intravenous injection

Objective:To investigate the efficacy and safety of intravenous methylene blue reducing the pain associated with propofol injectionMethods:180 patients aged 18-50 years old,ASAⅠ-Ⅱ,were randomly and equally divided into 3 groups:two test groups (group M and group L) and one control group(group C).Methylene blue 20mg and 2% lidocaine 40mg were given separately in group M and group L before injection of propofol. Meanwhile,the same volumetric normal saline was injected in group C.1% propo-fol was intravenously injected with a rate of 0.5 ml/s until patients lost consciousness.The frequency and severity of propofol injection pain were documented with a Ambesh 4-point scale.All patients were followed up by phone call about adverse reactions after 1 d.Re-sults:178 of 180 patients were completed and enrolled in the study. The rate of injection pain was 91.5% in group C, significantly higher than the rates of the two test groups,respectively (P<0.017,40.0% in group M and 27.1% in group L). But no statistical difference was found between the two test groups in the rate of injection pain.Group C mainly presented with a moderate-severe pian, but the two test groups only showed a mild-moderate injection pain.All patients declared no adverse reactions happened by telephone interview excepted 2 patients refused.Conclusions:Methylene blue may replaced lidocaine to effectively reduced the pain of propofol intravenous injection.