局部加温联合静脉预注利多卡因防治罗库溴铵注射痛的有效性  

Efficacy on the prevention and treatment of rocuronium injection pain by local warming combined with intravenous preinjection of lidocaine

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作  者:李佳新 牛望 丁林 李茜[1] LI Jiaxin;NIU Wang;DING Lin;LI Qian(Department of Anesthesia Surgery,West China Hospital,Sichuan University,Chengdu 6140011,China;Department of Anesthesiology,Sichuan Jinxin Women and Children's Hospital Chengdu 610011,China)

机构地区:[1]四川大学华西医院麻醉手术中心,成都610041 [2]四川锦欣妇女儿童医院麻醉科,成都610000

出  处:《西南医科大学学报》2023年第2期152-157,共6页Journal of Southwest Medical University

基  金:国家重点研发计划(2018YFC2001802-2)。

摘  要:目的评价局部加温联合静脉预注利多卡因防治罗库溴铵注射痛的有效性。方法本研究采用单中心随机双盲对照研究。纳入华西医院2022年3~6月行全麻手术的病人388例,年龄18~65岁,ASAⅠ~Ⅲ级。采用随机数字表法将病人分为4组:对照组、局部加温组、利多卡因组、局部加温联合利多卡因组,每组97例。对照组和局部加温组温度分别设置为32℃和43℃,均预注0.9%生理盐水2 mL;利多卡因组和局部加温联合利多卡因组温度分别设置为32℃和43℃,均预注2%利多卡因2 mL。记录推注罗库溴铵时注射痛肢体回缩反应分级、心率、血压等相关不良事件情况。结果对照组、局部加温组、利多卡因组及局部加温联合利多卡因组罗库溴铵注射痛发生率分别为60.8%、53.6%、30.9%及27.8%。相比对照组或局部加温组,局部加温联合利多卡因组罗库溴铵的注射痛发生率、中重度注射痛的发生率及注射痛的严重程度明显降低(P<0.05),但与利多卡因组相比差异无统计学意义(P>0.05)。没有留置针脱落或错位等不良事件发生;年龄越小、留置针直径越小的病人发生罗库溴铵注射痛的风险越高,有丙泊酚注射痛的病人也更容易出现罗库溴铵注射痛。结论局部加温联合静脉预注利多卡因可有效减少罗库溴铵注射痛发生率,但和静脉预注利多卡因相比,局部加温联合静脉预注利多卡因不能更有效降低罗库溴铵注射痛发生率。Objective To evaluate the effectiveness of local warming combined with intravenous preinjection lidocaine for the prevention and treatment of rocuronium injection pain.Methods This study was a single center,randomized,double-blind study.A total of 388 patients,aged 18~65 years,ASA classⅠ~Ⅲ,who underwent general anesthesia surgery from March to June 2022 in West China Hospital were included.The patients were randomly divided into four groups:control group,local warming group,lidocaine group,and local warming combined with lidocaine group,with 97 patients in each group.The temperature settings of the control group and the local warming group were 32℃and 43℃respectively,and 2 ml of 0.9%normal saline was preinjected;the temperature settings of lidocaine group and local warming combined with lidocaine group were 32℃and 43℃respectively,and 2 ml lidocaine was preinjected.Grade of withdrawal response,heart rate,blood pressure and dislodgement of indwelling needle in painful limbs during rocuronium injection as a bolus injection were recorded.Results the incidence of rocuronium injection pain was 60.8%,53.6%,30.9%and 27.8%in the control group,local warming group,lidocaine group and local warming combined with lidocaine group,respectively.Compared with the control group or the local warming group,the incidence of injection pain,the incidence of moderate and severe injection pain and the severity of injection pain in the local warming combined with lidocaine group were significantly reduced(P<0.05),but there was no significant difference compared with the lidocaine group(P>0.05).No adverse events such as dropping or dislocation of the retaining needle occurred.The younger the age and the smaller the diameter of the retaining needle,the higher the risk of rocuronium injection pain,and the patients with raw propofol injection pain were also more likely to have rocuronium injection pain.Conclusion Local warming combined with intravenous preinjection of lidocaine could reduce the incidence of rocuronium injection pa

关 键 词:罗库溴铵 局部加温 利多卡因 注射痛 

分 类 号:R57[医药卫生—消化系统]

 

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