利多卡因、曲马多和枢复宁对预防罗库溴铵注药痛的对比研究  

The Prevention of Pain from Injection of Rocuronium by Lidocaine, Tramadol and Ondansetron

作　　者：曾婉华[1] 欧阳葆怡[1] 

机构地区：[1]广州医学院第一附属医院麻醉科,广东广州510120

出　　处：《海南医学》2005年第8期30-32,共3页Hainan Medical Journal

摘　　要：目的观察罗库溴铵注药痛的发生率、致痛程度以及预先注射药物的预防效果。方法拟行全身麻醉的成年手术患者125例。麻醉诱导时用限时法给予肌松药。按静脉注射罗库溴铵前预先注射的药物将患者随机分为5组,每组25例。Ⅰ组生理盐水3ml、Ⅱ组利多卡因0.5mg/kg、Ⅲ组曲马多1.0mg/kg、Ⅳ组曲马多1.5mg/kg和Ⅴ组枢复宁0.07mg/kg。左上臂包裹气压止血带,加压至70mmHg阻断静脉回流后,以3ml/10s的速度在左侧手背静脉注入各组预先给予的药物,30s时松开止血带。立即10s注射罗库溴铵0.6mg/kg,观察并询问患者注药局部的痛感,并对疼痛反应评估分组。结果Ⅰ组罗库溴铵注药痛发生率达到88%,中、重度注药痛发生率为44%。Ⅱ组84%的患者无注药痛,16%的患者痛感轻微。Ⅲ组、Ⅳ组和Ⅴ组注药痛发生率分别为84%、76%和72%,与Ⅰ组相似;但Ⅲ组和Ⅴ组中、重度注药痛发生率(16%和4%)比Ⅰ组明显减少。结论麻醉诱导时预先静脉注射利多卡因0.5mg/kg,能有效降低罗库溴铵注药痛的发生率和致痛程度;预注曲马多或枢复宁亦能降低中、重度注药痛的发生率。Objective To observe the incidence and the degree of pain caused by injection of rocuronium, and to seek effective prophylaxes. Methods 125 adult patients scheduled for surgeries under general anesthesia were randomized into five groups (25 per group). The neuromuscular blocking drug was given according to timing principle during anesthetic induction period. Intravenous catheterization was made in dorsum of left hand and tourniquet compression with a pressure of 70 mmHg was applied to the left upper arm, then patients of groupⅠ,Ⅱ,Ⅲ,Ⅳ and Ⅴ received intravenous saline 3ml, lidocaine 0.5mg/kg, tramadol 1mg/kg, tramadol 1.5mg/kg and ondansetron 0.07mg/kg, respectively. 30s later, tourniquet compression was removed and rocuronium 0.6mg/kg was injected intravenously in 10s. Then the patients were observed and asked immediately if they had pain in the arm. Pain reactions, including malaise and pain in left hand, hand withdrawal, and so on, were recorded and assessed. Results Patients of group Ⅰ,Ⅲ,ⅣandⅤ presented a pain incidence of 88%, 84%, 76% and 72%, respectively (P>0.05). On the contrary, 84% of the patients in group Ⅱ did not have any feeling of pain, and 16% of those felt only mild pain (P<0.05). The incidence of moderate and severe pain of group Ⅲ and Ⅴ(16% and 4%, respectively )is significantly lower than that of groupⅠ(44%)(P<0.05). Conclusions Intravenous lidocaine 0.5mg/kg injected prior to anesthetic induction effectively lowers the incidence of pain caused by intravenous rocuronium and decreases the degree of pain, while prophylactic intravenous tramadol and ondansetron lowers the incidence of moderate and severe pain caused by rocuronium injection.

关 键 词：罗库溴铵 注药痛 利多卡因 曲马多 枢复宁 

分 类 号：R971.2[医药卫生—药品]