苏芬太尼对异丙酚静脉注射疼痛的预防作用观察  

The prevention of propofol-induced pain by sufentanyl:a placebo-controlled comparison with lidocaine

作　　者：裘卫东 张燕影[2] 朱小平[2] 

机构地区：[1]浙江省临海市第一人民医院,临海317000 [2]复旦大学附属中山医院麻醉科,上海200032

出　　处：《江西医药》2004年第2期85-88,共4页Jiangxi Medical Journal

摘　　要：目的　与利多卡因和对照组比较 ,观察苏芬太尼对异丙酚注射引起的疼痛缓解程度。方法　选择 1 60例ASAI-II级的病人行胃癌根治术、肝肿瘤切除术、胆囊切除术、结肠切除术等随机分为 4组 ,组I在施行异丙酚诱导之前 60s,给与苏芬太尼 50mg(2ml) ;组II在施行异丙酚诱导之前 60s给与利多卡因 40mg(2ml) ,组III在施行异丙酚诱导之前 60s给与苏芬太尼 50mg+利多卡因 40mg(2ml) ;组IV对照组在施行异丙酚诱导之前 60s给与生理盐水 (2ml)。根据Ambesh法进行疼痛评分观察每组疼痛的发生率。结果　与组IV相比 ,组I、组II和组III静脉异丙酚注射疼痛发生率降低 (P <0 .0 5) ,组III较组I、组II疼痛的发生率更低 (P <0 .0 5) ,而组I、组II间疼痛的发生率无显著差异(P >0 .0 5)。结论　苏芬太尼作为麻醉的辅助用药与利多卡因一样可降低异丙酚引起的静脉注射痛 ,与利多卡因之间无明显差异 ,而苏芬太尼与利多卡因和用有协同作用 ,静注异丙酚的疼痛发生进一步降低。Objective In a randomised, double-blinded study we compared the efficacy of sufentanyl infusion with 40mg lidocaine and placebo in the prevention of injection pain due to intravenous propofol administration. Methods 160 patients scheduled for elective surgery were randomly divided into four grougs. Group I received sufentanyl 50mg(2ml) over 60s before propofol injection. Group II received lidocaine 40mg(2ml) over 60s before propofol injection. Group III received sufentanyl50mg and lidocaine 40mg(2ml) over 60s before propofol injection. Group IV received saline 0.9%(2ml) over 60s before propofol injection. Propofol administration followed a standard protocol with a dose 1.5～2 mg/kg. Pain score were recorded according to Ambesh four-point scale system. Results Compare with the placebo group the incidence of injection pain was 52.5%, GroupI (32.5%, P< 0.05)、group II(35%, P<0.05) and group III (17.5%, P<0.05) could significantly reduce the incidence of injection pain. Analysis of the pain scores showed a significant difference between group III and group I group II(P<0.05). Compare with group II\, group I could not reduce the pain rate(P< 0.05). Conclusion Sufentanyl provided effective pain relief, comparable with placebo. There was no significant difference between sufentanyl and lidocaine. Combined sufentanyl and lidocaine, there was cooperation effect of pain relief.

关 键 词：苏芬太尼 异丙酚 静脉注射 疼痛 预防 利多卡因 

分 类 号：R614[医药卫生—麻醉学] R971.2[医药卫生—外科学]