利多卡因与芬太尼用于预防丙泊酚注射痛的比较性研究

Prevention of pain on injection of propofol:a comparison of lidocaine with fentanyl

目的:比较两种剂量利多卡因和芬太尼预防丙泊酚注射痛的效果。方法:将200例择期行手术的女性病人随机分成4个组,每组50例。前臂扎止血带后分别静脉注A组:利多卡因0.5 mg/kg,B组:利多卡因40 mg,C组:芬太尼50μg,D组:生理盐水2 ml。60 s后松止血带,静脉注射丙泊酚。注射期间使用4分法对注射痛评分。麻醉清醒后使用VAS评分法对注射痛再次评分。结果:4组注射痛发生率分别是38%(19例)、50%(25例)、64%(32例)、80%(40例)。VAS评价4组注射痛发生率分别是32%(16例)、44%(22例)、60%(30例)、74%(3例)。结论:扎止血带后静脉注射利多卡因0.5 mg/kg或40 mg并保留止血带1 min,均可降低丙泊酚注射痛的发生率和严重程度。

Objective：The purpose of this study was to compared the two dosage of lidocaine,with fentanyl,for prevention the injection pain of propofol.Methods：Two hundred female patients,scheduled for elective surgery,were divided into four groups randomly：（n=50） received either,lidocaine 0.5 mg/kg IV,lidocaine 40 mg IV,fentanyl 50 μg IV,or saline 2 ml IV,with venous occlusion for 60 seconds,followed by administration of propofol intravenously.Pain was assessed with a four-point scale at the time of propofol injection,and re-assessed using visual analogue scale（VAS） system when patients awake from anesthesia.Results：Using four-point scale system： the pain incidence were 38%（19 patients）,50%（25patients）,64%（32 patients）,80%（40 patients） respectively.Using VAS scores system： the pain incidence were： 32%（16 patients）,44%（22 patients）,60%（30 patients）,74%（37 patients） recall of pain respectively.Conclusion：Pretreatment with lidocaine 0.5 mg/kg or 40 mg along with venous occlusion for 1 min can reduce the incidence and severity of propofol-induced pain.