格拉司琼预处理对罗库溴铵注射痛和体动反应的影响

Effects of pretreatment with granisetron on injection pain and withdrawal response induced by rocuronium bromide

目的观察格拉司琼预处理对罗库溴铵注射痛和体动反应的影响。方法选取66例全麻下行择期骨科手术的患者,随机分为三组,每组22例。以止血带阻断上臂静脉回流,随后格拉司琼组、利多卡因组和对照组分别静脉注射格拉司琼3 mg、利多卡因40 mg和氯化钠注射液3 mL,1 min后松开止血带,静脉注射罗库溴铵0.6 mg·kg^(-1)。注射结束后10 s内采用疼痛数字评定量表(NRS)评分法和4级评定(FPS)法评估患者注射痛和体动情况,随即完成全麻诱导并行气管插管。观察注射部位局部皮肤情况及不良反应发生情况。结果三组静脉穿刺NRS评分和皮疹发生情况比较均无显著差异(P>0.05)。对照组罗库溴铵注射痛NRS评分高于格拉司琼组和利多卡因组(P<0.05),格拉司琼组和利多卡因组比较无显著差异(P>0.05);对照组注射痛发生率为90%(19/21),高于格拉司琼组和利多卡因组[45%(10/22)和55%(12/22),P<0.05],格拉司琼组和利多卡因组比较无显著差异(P>0.05)。格拉司琼组FPS评级低于利多卡因组和对照组(P<0.05),利多卡因组低于对照组(P<0.05)。结论格拉司琼预处理能显著降低罗库溴铵注射痛和体动反应的发生,效果优于利多卡因。

AIM To investigate the effects of pretreatment with granisetron on injection pain and withdrawal response induced by rocuronium bromide. METHODS Sixty-six patients undergoing elective orthopaedics operation under general anesthesia were randomly assigned into granisetron group, lidocaine group and control group with 22 patients in each group. Granisetron 3 mg, lidocaine 40 mg, sodium chloride injection3 m L were administered after tourniquet application. The occlusion was released after 1 min and rocuronium bromide 0.6 mg·kg^（-1） was injected. Pain and withdrawal movements were evaluated by pain numeric rating scale（ NRS） and four-point score（ FPS） within 10 s after rocuronium bromide injection, subsequently general anesthesia induction was completed. The reddening and rash in the local skin of the injection site were recorded and the adverse reactions were observed. RESULTS There were no significant difference in the NRS score of venipuncture and skin rash occurrence among three groups（P 0.05）. The NRS score of rocuronium bromide injection in the granisetron group and lidocaine group were significantly lower than that in the control group（ P 0.05）, and the difference between granisetron group and lidocaine group was not significant（P 0.05）.The incidence of injection pain in the control group was 90%（19/21）, which was significantly higher than that in the granisetron group and lidocaine group（45%（10/22） and 55%（12/22）, P 0.05）, and the difference between granisetron group and lidocaine group was not significant（ P 0.05）. The score of FPS in the granisetron group was significantly lower than that in the lidocaine group and control group（P 0.05）, and the score of FPS in the lidocaine group was significantly lower than that in the control group（ P 0.05）.CONCLUSION Pretreatment with granisetron can effectively reduce the pain and occurrence of withdrawal response which are associated with the injection of rocuronium bromide, and it is superior to lidocaine.