小剂量艾司洛尔对丙泊酚麻醉诱导静脉注射疼痛的影响

Effect of low-dose esmolol on vascular pain during anesthesia induction with propofol

目的研究小剂量艾司洛尔对丙泊酚麻醉诱导静脉注射疼痛的影响。方法选择2007年6月至2008年3月全身麻醉下行择期手术的患者80例，随机分为对照组（A组）和艾司洛尔组（B组），每组40例。A组进行常规麻醉诱导，B组先静脉注射艾司洛尔0．5mg/kg，30s后再进行常规麻醉诱导。采用4分制对两组的丙泊酚注射痛进行评分，比较麻醉前、诱导完毕、气管插管完成即刻、气管插管后2、4、6、8与10min的血压和心率变化及诱导期间注射痛的发生率。结果两组麻醉前和诱导期间各时点血压和心率的变化差异无统计学意义（均P〉0．05）。诱导期间丙泊酚总的注射疼痛发生率A组为65％（26／40），B组为23％（9／40）（P〈0．01）。其中重度疼痛发生率A组为20％（8／40），B组为3％（1／40）（P〈0．05）；而轻度和中度疼痛发生率两组间差异无统计学意义（P〉0．05）。结论小剂量艾司洛尔可减轻丙泊酚麻醉诱导的静脉注射疼痛。

Objective To evaluate the effect of low- dose esmolol on vascular pain during anesthesia induction with propofol. Methods Eighty patients who underwent general anesthesia between June 2007 and March 2008 were randomly assigned to the control group （group A） or the esmolol group （group B） , with 40 patients in each. Propofol was administrated 2 mg/kg in 20 s i. v. to initiate anesthesia induction in all the patients. In group B, 0.5 mg/kg esmolol was administrated 30 s i. v. before anesthesia induction. Vascular pain with propofol administration was evaluated in both groups using a 4-point scale. Arterial blood pressure and heat rate were measured and compared between two groups before induction, at the end of induction, at the end of intubation and at 2, 4, 6, 8, 10 min after intubation, as well as vascular pain during induction. Results The blood pressure and heart rate remained comparable between both groups before anesthesia and across all time spots of anesthesia induction （all P〉0.05）. Twenty-six patients （65%） in group A and 9 （23%） in group B reported pain during anesthesia induction （P〈0.01）. There was no significant difference in mild pain or moderate pain between two groups （P〉0.05）. Severe pain was reported in 8 patients （20%） in group A compared with 1 （3%） in group B （P〈0.05）. Conclusion Low-dose esmolol may reduce vasclular pain by propofol injection during anesthesia induction.