混合预注舒芬太尼及利多卡因在无痛胃镜检查中缓解丙泊酚注射痛的临床观察

Clinical Observation on Pre-injection of Sufentanil Combined with Lidocaine for Alleviating the Pain Due to Propofol Injection in Painless Gastroscopy

【目的】观察预给舒芬太尼和（或）利多卡因预防无痛胃镜检查中丙泊酚注射痛的效果。【方法】采用双盲法，选择行无痛胃镜检查的患者200例，随机分为舒芬太尼组（S组）、利多卡因组（L组）、舒芬太尼联合利多卡因组（SL组）及生理盐水组（C组），每组50例。给予丙泊酚前1min，四组患者分别静脉注射舒芬太尼（0．2μg／kg，2mL）、利多卡因40mg（2mL）、舒芬太尼＋利多卡因（0．2μg／kg＋40mg）以及生理盐水（2mL）。所有患者以0．5mL／s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C组比较，L组、S组及SL组注射痛发生率和严重程度均明显降低（P〈0．05），与S组及L组比较，SL组注射痛发生率及严重程度明显降低（P〈0．05）。【结论】预给舒芬太尼或利多卡因均可有效减少丙泊酚注射痛的发生率以及减轻丙泊酚注射痛的严重程度，且联合舒芬太尼及利多卡因效果更佳。

[Objective] To observe the efficacy of pretreatment with sufentanil and/or lidocaine for the pre- vention of pain due to propofol injection in painless gastroscopy. [Methods] Totally 200 patients undergoing painless gastroscopy were randomly divided into sufentanil group（group S）, lidocaine group（group L）, sufen- tanil combined with lidocaine group（group SL） and normal saline group（group C） with 50 cases in each group by using double blind method. The patients in 4 groups received the intravenous injection of 2ml sufentanil 0.2 μg/kg, 40mg（2ml） lidocaine, 0. 2μg/kg sufentanil ＋ 40mg lidocaine or 2ml normal saline at lmin before propofol injection, respectively. All patients received intravenous injection 100mg propofol at the rate of 0.5 ml/s. An anesthesia physician observed the incidence and severity of injection pain from the beginning of pre- injection to the end. [Results]Compared with group C, the incidence and severity of injection pain in group L, S and SL obviously decreased（ P 〈0.05）. Compared with group S and L, the incidence and severity of injec- tion pain in group SL obviously decreased（ P 〈0.05）. [Conclusion]Pre-injection of sufentanil or lidocaine can effectively reduce the incidence and severity of pain due to propofol injection. Sufentanil combined with lido- caine has better efficacy.