木质素与碳酸氢钠对减轻异丙酚静脉注射疼痛的效果:一项前瞻性随机双盲对照研究

Karim Mourad, Sahar Marzouk, Aliaa Mohammed, Ayman Abougabal
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摘要

背景 异丙酚是最常用的静脉注射麻醉药物,用于麻醉诱导和镇静,但在注射过程中出现的疼痛仍是一个问题。大约 70% 至 90% 接受异丙酚麻醉诱导的病人在注射过程中会感到疼痛,而且这种疼痛可能相当剧烈。最常用的减轻丙泊酚注射疼痛的药物是静脉注射利格诺卡因,它通过对静脉的局部麻醉作用发挥作用。事实证明,在利多卡因中加入碳酸氢钠可增加钠离子浓度,并通过其缓冲作用提高血清 pH 值,从而减轻异丙酚注射时的疼痛。目的 比较在异丙酚中加入利多卡因和碳酸氢钠对减轻异丙酚注射疼痛的效果。设置和设计 随机、对照、双盲试验。方法和材料 180 名在手术过程中接受有意识镇静的患者被随机分为以下三个等量组:L 组:3 毫升(60 毫克)2% 的木质素与异丙酚预混;B 组:3 毫升 8.5% 的碳酸氢钠与异丙酚预混;S 组:3 毫升生理盐水与异丙酚预混。采用四点口头评分法和血压法比较 3 组患者在静脉注射异丙酚后的疼痛强度。结果 与两组(生理盐水 81% 和碳酸氢盐 71%)相比,木质碱组的疼痛发生率和疼痛评分(43%)明显较低,P 值 < 0.001。结论 我们的研究表明,与将异丙酚与碳酸氢钠或生理盐水混合使用相比,将木质碱与异丙酚混合使用似乎能有效降低异丙酚注射过程中疼痛的发生率和严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of lignocaine versus sodium bicarbonate on reducing pain due to intravenous injection of propofol: a prospective randomised double-blinded, controlled study
Context Propofol is the most commonly used intravenous (IV) anesthetic drug for induction of anaesthesia and for sedation, but pain which occur during its injection still remains a problem. Approximately 70 to 90% of patients who receive propofol for anaesthesia induction experience pain during injection and this pain can be quite severe. The most frequently used drug to alleviate pain in propofol injection is IV Lignocaine which acts through the local anesthetic effect on the veins. Administration of sodium bicarbonate with lidocaine was proved to reduce pain in propofol injection through increasing sodium ions concentration as well as increasing serum pH through its buffering effect. Aims To compare the effect of adding lignocaine vs sodium bicarbonate to propofol in reducing pain on propofol injection. Settings and design A randomized, controlled, double-blinded trial. Methods and material One hundred and eighty patients underwent conscious sedation during surgical procedures were randomly divided into three equal groups as follows: Group (L) 3 ml (60 mg) of lignocaine 2% premixed with propofol, group (B) 3 ml of sodium bicarbonate 8.5% premixed with propofol and group (S) 3 ml of normal saline premixed with propofol. The 3 groups were compared regarding pain intensity immediately after IV injection of propofol using the four-point verbal rating and BP. Results The incidence of pain and the pain score were significantly lower in the lignocaine group (43%) in comparison to both group (Saline 81% and bicarbonate 71%) P value < 0.001. However, no difference in pain score or the incidence of pain were found between Group S and Group B. Conclusions Our study demonstrated that mixing lignocaine with propofol appears to be effective in reducing both the incidence and severity of the pain during propofol injection when compared to mixing propofol with sodium bicarbonate or normal saline.
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