格拉司琼复合利多卡因静脉预处理减轻异丙酚所致注射痛和呕吐的临床观察

Clinical Efficacy of Granisetron Combined with Lidocaine Pretreatment in Minimizing Propofol Injection Pain and Vomiting

目的:观察特异性5-HT受体拮抗药格拉司琼复合利多卡因进行静脉预处理以减轻临床中静脉注射异丙酚引起注射痛和呕吐的随机、双盲、对照临床效果。方法:400例拟行腹腔镜胆囊摘除手术的患者,随机分为对照组(A组)、利多卡因组(B组)、格拉司琼组(C组)和格拉司琼复合利多卡因组(D组),每组100例。A组患者给予氯化钠注射液3mL;B组患者给予利多卡因20mg;C组患者给予格拉司琼2mg;D组患者给予2mg格拉司琼和20mg利多卡因混合液。1min后松开止血带,并推注1/4预计量异丙酚,同时记录注射部位疼痛评分。结果:B、C、D组与A组比较,注射痛发生的数量和程度差异有统计学意义(P<0.05)。D组与B、C组比较,注射痛发生的数量和程度差异也有统计学意义(P<0.05)。B、C组间比较注射痛发生的数量和程度差异无统计学意义(P>0.05)。D组异丙酚注射痛、术后恶心呕吐及寒战的发生率更低(P<0.05)。结论:特异性5-HT受体拮抗药格拉司琼复合局麻药利多卡因进行静脉预处理可以有效减轻术中异丙酚注射痛,并且还能预防术后恶心呕吐及寒战。

OBJECTIVE：To observe clinical efficacy of specific 5-HT receptor antagonist granisetron combined with intravenous local anesthetic lidocaine pretreatment in minimizing propofol injection pain. METHODS：400 selective patients with laparoscopic cholecystectomy randomized into control group（group A）,lidocaine group（group B）,granisetron group（group C）and lidocaine combined with granisetron group（group D）,n=100. Group A were treated with 3 mL normal saline and group B 20 mg lidocaine,group C 2 mg granisetron,group D 2 mg granisetron and 20 mg lidocaine. After 1 min the tourniquet released and a quarter of expected amount of propofol was given. Pain score of injection site was recorded. RESULTS：As group B、C and D,case number of injection nonpain in group A was higher than that of injection pain. There were statistical significance in the difference of case number and degree of injection pain among those groups（P0.05）. As compared with group B and C,case number of injection nonpain in group D was higher than that of injection pain. There were statistical significance in the difference of case number and degree of injection pain among those groups（P0.05）. There was no statistical significance in the difference of case number of injection pain and the incidence of chill between group B and C. The incidence of injection pain and chill were the lowest among those groups（P0.05）. However,The incidence of injection pain,vomiting and chill in. Group D were better than those group（P0.05）. CONCLUSION：Specific 5HT receptor antagonist granisetron combined with intravenous local anesthetics lidocaine pretreatment could effectively reduce propofol injection pain and also prevent postoperative nausea and vomiting and chills.