对比地佐辛、曲马多和布托啡诺预防丙泊酚注射痛的临床效果

Comparison of clinical efficacy among dezocine,tramadol and butorphanol in the prevention of propofol injection pain

目的观察地佐辛、曲马多、布托啡诺用于预防丙泊酚注射痛的临床疗效。方法将2016年10月在我院住院的128例拟定在全身麻醉下择期行手术治疗,且曾经接受过丙泊酚注射出现注射痛的患者,随机分为4组:生理盐水组、地佐辛组、曲马多组、布托啡诺组,每组均为32例。生理盐水组预先注射生理盐水3ml,地佐辛组预先注射10mg地佐辛,曲马多组预先注射50mg曲马多,布托啡诺组预先注射1mg布托啡诺。2min后,所有组均静脉注射0.5mg/kg丙泊酚,评价各组注射部位的疼痛情况。结果生理盐水组出现28例(87.50%)不同程度以中、重度为主的疼痛,曲马多组出现疼痛20例(62.50%),布托啡诺组出现疼痛13例(40.63%),地佐辛组出现疼痛4例(12.50%),生理盐水组与其他三组相比差异均有统计学意义(P均<0.05)。从疼痛例数及疼痛程度上来看,预防丙泊酚注射痛效果从优到差依次是地佐辛、布托啡诺、曲马多。结论静脉预先注射止痛药物可以有效减轻丙泊酚注射液造成的注射痛,其效果从优到差依次是地佐辛、布托啡诺、曲马多,临床上应结合患者自身情况,在对缓慢推注丙泊酚仍有强烈注射痛的患者可选择地佐辛或者布托啡诺。

Objective To observe the clinical efficacies of dezocine,tramadol and butorphanol in the prevention of propofol injection pain. Methods In October 2016,128 cases underwent selective surgical treatment under general anesthesia and had propofol injection pain when they were injected with propotol were randomly divided into 4 groups：saline group,dezocine group,tramadol group and butorphanol group,each group had 32 cases.Saline group received intravenous pre-injection of saline solution 3 ml,dezocine group with intravenous pre-injection of 10 mg dezocine,tramadol group with intravenous pre-injection of 50 mg tramadol,and butorphanol group with intravenous pre-injection of 1 mg butorphanol.Two minutes later,all patients received intravenous injection of 0.5 mg/kg propofol.The scores of injection site pain were recorded and compared within the 4 groups. Results Twenty-eight cases of saline group（87.50%）had different degrees of pain（mostly mild and severe pain）,20 cases（62.50%）of tramadol group had pain,13 cases（40.63%）of butorphanol group had pain,4 cases（12.50%）of dezocine group had pain,compared saline group with the other three groups showed that there were all statistically significant differences（all P 0.05）.From the angle of pain number and degree,the efficacy of prevention of propofol injection pain from good to worse ranked as the following：dezocine,butorphanol and tramadol. Conclusion Intravenous injection of analgesic drugs can effectively reduce injection pain caused by propofol injection,the good preventive effect ranks as dezocine,butorphanol and tramadol.Clinically,dezocine or butorphanol shall be a good choice for patients who have severe pain when they are given slowly intravenous injection of propofol.