利多卡因、芬太尼和布托啡诺分别用于预防丙泊酚注射痛的疗效观察  

Pain during injection of propofol:the effect of pretreatments of fentanyl,lidocaine,or butorphanol

作　　者：曾睿峰[1] 唐岩峰[1] 何伟[1] 李军[1] 连庆泉[1] 

机构地区：[1]温州医学院附属第二医院麻醉科,温州325027

出　　处：《海峡药学》2009年第10期103-106,共4页Strait Pharmaceutical Journal

摘　　要：目的观察预给利多卡因、芬太尼或布托啡诺预防丙泊酚注射痛的效果。方法采用双盲法,选择符合标准择期手术病人160例,随机分为A组(布托啡诺组)、B组(利多卡因组)、C组(芬太尼组)和D组(对照组),每组40例。麻醉诱导前1min,四组病人分别静脉注射布托啡诺1mg(2mL)、利多卡因40mg(2mL)、芬太尼0.05mg(2mL)或生理盐水2mL。然后,所有病人以每秒0.5mL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。结果与对照组比较,利多卡因组和布托啡诺组注射痛发生率和严重程度明显降低(P<0.05),芬太尼组注射痛发生率降低但无统计学意义,严重程度明显降低(P<0.05),各试验组效果:布托啡诺组≈利多卡因组>芬太尼组。结论预给布托啡诺或利多卡因均可有效减少和减轻丙泊酚注射痛,但预给芬太尼不能有效减少疼痛发生率只能减轻疼痛程度。OBJECTIVE To compare the effect of pretreatment with fentanyl, lidocaine, or butorphanol for prevention of pain associated with propofol injection. METHODS This study was conducted in a randomized double-blind fashion. 160 adult patients undergoing elective surgical procedures without difficulty in communication were divided into four groups randomly： Group A （Ⅳ butorphanol 1mg, n = 40）, Group B （Ⅳ 2% lidocaine 40mg, n = 40）, Group C （ Ⅳfentanyl 0.05mg, n = 40）, Group D （Ⅳ normal saline 2mL, n = 40 ; as placebo control）. All patients received pretreatment solutions（butorphanol lmg, 2% lidocaine 40 mg, fentanyl 0.05mg, normal saline） 1 min before induction of anesthesia with propofol depending on the group to which they belonged. Patients then received 100 mg propofol at the rate of 0.5 mL/s. Patients were continuously observed the incidence and severity of pain associated with Ⅳ injection of propofol. RESULTS Butorphanol and Lidocaine sig-nificantly reduced propofol injection pain more than placebo （P 〈 0.05）. Fentanyl reduced the intensity of propofol injection pain （P 〈 0.05） and had some effect in reducing the incidence of propofol injection pain, but the di ference did not reach statistical significance. The order of efficacy was butorphanol ≈lidocaine 〉 fentanyl.CONCLUSlON Pretreatments with lidocaine or butorphanol is effective in reducing propofol injection pain, whereas fentanyl only slightly reduced the propofol injection pain.

关 键 词：注射痛 丙泊酚 布托啡诺 利多卡因 芬太尼 

分 类 号：R969.4[医药卫生—药理学]