芬太尼预防罗库溴铵注药痛的研究  

Prevention of pain from injection of rocuronium by fentanyl

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,510120

出　　处：《临床麻醉学杂志》2007年第2期110-112,共3页Journal of Clinical Anesthesiology

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芬太尼的预防效果。方法拟行全身麻醉的成年手术患者175例。麻醉诱导时用限时法给予罗库溴铵。按给予罗库溴铵前的处理方法将患者随机分成七组，每组25例。～Ⅳ组将左上臂包裹的气压止血带加压至70mmHg以阻断静脉回流。于左手背静脉注射预处理药物：Ⅰ组为生理盐水3ml；Ⅱ～Ⅳ组为芬太尼2μg／kg，速度3ml／10s。Ⅰ组和Ⅱ组注药后30S松开止血带，Ⅲ组和Ⅳ组分别于注药后60S和120S松开止血带，立即在该静脉10S内注入罗库溴铵0．6mg／kg。Ⅴ～Ⅶ组不用止血带，以3ml／10s速度注入芬太尼2μg／kg；Ⅴ组、Ⅵ组和Ⅶ组分别在注药后30、60S和120S后于该静脉10S内注入罗库溴铵0．6mg／kg。观察患者在注射罗库溴铵时的反应，并对各种反应评估分级。结果罗库溴铵注药痛发生率Ⅰ组达92％，明显高于Ⅳ组（64％）和Ⅶ组（52％）（P〈0．01）；Ⅰ组中、重度注药痛发生率达56％，而Ⅳ组和Ⅶ组均为轻度疼痛。Ⅳ组与Ⅶ组注药痛组间比较差异无统计学意义。Ⅱ组和Ⅲ组注药痛发生率均为84％，V组和Ⅵ组分别为96％和88％，和Ⅰ组相似。Ⅵ组中、重度注药痛发生率（12％）比Ⅰ组明显减少（P〈o、05）。结论麻醉诱导时预先静脉注射芬太尼2μg／kg，不论是否用止血带阻断静脉回流，120S后再注入罗库溴铵时，均能有效降低罗库溴铵注药痛的发生率和致痛程度。Objective To study the preventive effect of fentanyl on the incidence and degree of pain caused by injection of rocuronium. Methods One hurdred and seventy-five adult patients scheduled for surgeries under general anesthesia were randomized into 7 groups with 25 cases each. Rocuronium was given according to timing principle during anesthetic induction. All patients were catheter- ized in dorsum of left hand. In group Ⅰ -Ⅳ, tourniquet compression with a pressure of 70 mmHg was applied to the left upper arm,then the patients in group Ⅰ and Ⅱ-Ⅳ received intravenous saline 3 ml or fentanyl 2μg/kg in 10 s,respectively. Tourniquet compression was released in group Ⅰ and Ⅱ , Ⅲ and Ⅳ at 30 s, 60 s and 120 s after fentanyl injection, respectively, then rocuronium 0.6 mg/kg was injected intravenously in 10 s. Patients in group Ⅴ-Ⅶ were not tourniquet-compressed and received intravenous fentanyl 2μg/kg at a injection speed of 3 ml/10 s. In group Ⅴ,Ⅵ and Ⅶ ,rocuronium 0. 6 mg/kg was injected intravenously in 10 s at 30 s,60 s and 120 s after fentanyl administration, respectively. The patients then were observed and asked immediately if they had pain in the arm. Pain reactions were recorded and assessed. Results The incidence of pain in group Ⅰ （92%） was significantly higher than that in group Ⅳ （64%）and group Ⅶ （52%）（P〈0. 01）. The incidence of moderate and severe pain of group Ⅰ was 56% ,and the patients in group Ⅳ and Ⅶ felt only mild pain. The incidence of pain between group Ⅳ and Ⅶ was not significantly different. The incidence of pain of group Ⅱ ,Ⅲ ,Ⅴ and Ⅵ （84% ,84% ,96% and 88% ,respectively）was similar to that of group Ⅰ . The incidence of moderate and severe pain of group Ⅵ （12%）was significantly lower than that of group Ⅰ （56%） （P〈0.05）. Conclusion Intravenous fentanyl 2μg/kg injected 120 s before intravenous rocuronium 0.6 mg/kg, regardless of tourniquet compression, effectively lowers the incidence of pain caused by in

关 键 词：罗库溴铵 注药痛 芬太尼 

分 类 号：R614[医药卫生—麻醉学]