氟比洛芬酯和利多卡因聯用緩解異丙酚注射痛的隨機對照研究_《中國循證醫學雜志》

作者：

李毅 , 司琪 ,  江曉菁

中國醫科大學附屬第一臨床學院麻醉科（沈陽?110001）;

關鍵詞：

氟比洛芬酯利多卡因異丙酚注射痛隨機對照試驗

DOI：

10.7507/1672-2531.20110210

視頻：

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目的　探討聯合應用氟比洛芬酯和利多卡因做靜脈預處理緩解異丙酚注射痛的效果。
方法　將160例擬行擇期手術的ASI 1～2級全麻患者隨機分為對照組、利多卡因組（Lc組）、氟比洛芬酯組（FA組）和氟比洛芬酯和利多卡因聯用組（聯用組），每組各40例。所有患者在給藥前均先以橡膠止血帶阻斷其局部靜脈回流，隨后分別給予對照組0.9% NS 7 mL，FA組氟比洛芬酯注射液5 mL（50 mg）+0.9% NS 2 mL，Lc組2%利多卡因 2 mL（40 mg）+0.9% NS 5 mL，聯用組氟比洛芬酯注射液5 mL（50 mg）+2%利多卡因2 mL（40 mg）；2 min后撤止血帶，在5 s內給入0.5 mg/kg的異丙酚。給藥同時由另一位麻醉師以相同的方式及問題詢問患者注射部位情況，采用VRS評分。
結果　4組間一般情況比較無明顯差異。Lc組、FA組、聯用組的異丙酚注射痛發生率明顯低于對照組（P lt;0.05），聯用組疼痛發生率低于其余3組。在注射痛強度評分方面，Lc組和聯用組的疼痛強度明顯低于對照組。術后24 h隨訪，患者注射部位無紅腫、靜脈炎或藥疹等不良反應情況，亦無預期的胃腸刺激癥狀。
結論　氟比洛芬酯和利多卡因聯用做靜脈預處理可有效緩解異丙酚注射痛，且不會增加不良反應。

引用本文： 李毅,司琪,江曉菁. 氟比洛芬酯和利多卡因聯用緩解異丙酚注射痛的隨機對照研究. 中國循證醫學雜志, 2011, 11(11): 1247-1250. doi: 10.7507/1672-2531.20110210 復制

1.	1 Macario A, Weinger M, Truong P, et al . Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg , 1999, 88(5): 1085-1091.
2.	2 Hynyen M, Korttila K, Tammisto T. Pain on i.v. injection of propofol (ICI 35 868) in emulsion formulation: Short communication. Acta Anaesthesiologica Scandinavica , 1985, 29(6): 651-652.
3.	3 McCirrick A, Hunter S. Pain on injection of propofol: The effect of injectate temperature. Anaesthesia , 1990, 45(12): 1090-1091.
4.	4 Scott RP, Saunders DA, Norman J. Propofol: Clinical strategies for preventing the pain of injection. Anaesthesia , 1988, 43(6): 492-494.
5.	5 Pascale P, Tramèr MR. Prevention of Pain on Injection with Propofol: A Quantitative Systematic Review. Anesth Analg , 2000, 90(4): 963-969.
6.	6 Fujii Y, Shiga Y. Flurbiprofen axetil preceded by venous occlusion in the prevention of pain on propofol injection in the hand: a prospective, randomized, double-blind, vehicle-controlled, dose-finding study in Japanese adult surgical patients. Clinical Therapeutics , 2005, 27(5): 588-593.
7.	7 Fujii Y, Itakura M. Pretreatment With Flurbiprofen Axetil, FlurbiprofenAxetil Preceded by Venous Occlusion, and a Mixture of Flurbiprofen Axetil and Propofol in Reducing Pain on Injection of Propofol in Adult Japanese Surgical Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study. Clinical Therapeutics , 2009, 31(4): 721-727.
8.	9 Fujii Y, Nakayama M. Prevention of pain due to injection of propofol with IV administration of lidocaine 40 mg + metoclopramide 2.5, 5, or 10 mg or saline: a randomized, double-blind study in Japanese adult surgical patients. Clinical Therapeutics , 2007, 29(5): 856-861.
9.	10 Kwak HJ, Min SK, Kim JS, et al . Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone. Br J Anaesth , 2009, 103(3): 410-412.
10.	11 Kwak KH, Ha J, Kim Y, et al . Efficacy of combination intravenous lidocaine and dexamethasone on propofol injection pain: a randomized, double-blind, prospective study in adult Korean surgical patients. Clin Ther , 2008, 30(6): 1113-1119.
11.	13 Mangar D, Holak EJ. Tourniquet at 50mm Hg followed by intravenous lidocaine diminishes hand pain associated with propofol injection. Anesth Analg , 1992, 74(2): 250-252.
12.	14 King SY, Davis FM, Wells JE, et al . Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg , 1992, 74(2): 246-249.
13.	15 Smith I, White PF, Nathanson M, et al . Propofol. An update on its clinical use. Anesthesiology , 1994, 81(4): 1005-1043.
14.	16 Ferreira SH. Peripheral analgesia: Mechanism of the analgesic action of aspirin-like drugs and opiate antagonists. Br J Clin Pkarmacol , 1980, 10(Suppl 2): 237S-244S.
15.	17 Auerswald K, Pfeiffer F, Behrends K, et al . Pain on injection with propofol. Anasthesiol Intensivmed Notfallmed Schmerzther , 2005, 40(5): 259-266.
16.	18 Ohmukai O. Lipo-NSAID preparation. Advanced Drug Delivery Reviews , 1996, 20(2-3): 203-207.
17.	20 Ochroch EA, Mardini IA, Gottschalk A. What is the role of NSAIDs in pre-emptive analgesia? Drugs , 2003, 63(24): 2709-2723.
18.	21 Tan CH, Onsiong MK. Pain on injection of propofol. Anaesthesia , 1998, 53(5): 468-476.
19.	馬玉姍, 林雪梅, 周俊. 格拉司瓊復合利多卡因減輕異丙酚注射痛的隨機雙盲對照研究. 四川大學學報, 2009, 40(3): 536-538.
20.	Fleisher LA. Preoperative evaluation. In: Barash PG, Cullen BF, Stoelting RK, eds. Clinical Anesthesia. 3rd ed. Philadelphia, Pa: Lippincott-Raven, 1996: 443-459.
21.	Insel PA. Analgesic-antipyretic and anti-inflammatory agents and drugs employed in the treatment of gout. In: Hardman JG, Limbird LE, Molinoff PB, Rudon RW, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill; 1996: 617-657.

1. 1 Macario A, Weinger M, Truong P, et al . Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg , 1999, 88(5): 1085-1091.
2. 2 Hynyen M, Korttila K, Tammisto T. Pain on i.v. injection of propofol (ICI 35 868) in emulsion formulation: Short communication. Acta Anaesthesiologica Scandinavica , 1985, 29(6): 651-652.
3. 3 McCirrick A, Hunter S. Pain on injection of propofol: The effect of injectate temperature. Anaesthesia , 1990, 45(12): 1090-1091.
4. 4 Scott RP, Saunders DA, Norman J. Propofol: Clinical strategies for preventing the pain of injection. Anaesthesia , 1988, 43(6): 492-494.
5. 5 Pascale P, Tramèr MR. Prevention of Pain on Injection with Propofol: A Quantitative Systematic Review. Anesth Analg , 2000, 90(4): 963-969.
6. 6 Fujii Y, Shiga Y. Flurbiprofen axetil preceded by venous occlusion in the prevention of pain on propofol injection in the hand: a prospective, randomized, double-blind, vehicle-controlled, dose-finding study in Japanese adult surgical patients. Clinical Therapeutics , 2005, 27(5): 588-593.
7. 7 Fujii Y, Itakura M. Pretreatment With Flurbiprofen Axetil, FlurbiprofenAxetil Preceded by Venous Occlusion, and a Mixture of Flurbiprofen Axetil and Propofol in Reducing Pain on Injection of Propofol in Adult Japanese Surgical Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study. Clinical Therapeutics , 2009, 31(4): 721-727.
8. 9 Fujii Y, Nakayama M. Prevention of pain due to injection of propofol with IV administration of lidocaine 40 mg + metoclopramide 2.5, 5, or 10 mg or saline: a randomized, double-blind study in Japanese adult surgical patients. Clinical Therapeutics , 2007, 29(5): 856-861.
9. 10 Kwak HJ, Min SK, Kim JS, et al . Prevention of propofol-induced pain in children: combination of alfentanil and lidocaine vs alfentanil or lidocaine alone. Br J Anaesth , 2009, 103(3): 410-412.
10. 11 Kwak KH, Ha J, Kim Y, et al . Efficacy of combination intravenous lidocaine and dexamethasone on propofol injection pain: a randomized, double-blind, prospective study in adult Korean surgical patients. Clin Ther , 2008, 30(6): 1113-1119.
11. 13 Mangar D, Holak EJ. Tourniquet at 50mm Hg followed by intravenous lidocaine diminishes hand pain associated with propofol injection. Anesth Analg , 1992, 74(2): 250-252.
12. 14 King SY, Davis FM, Wells JE, et al . Lidocaine for the prevention of pain due to injection of propofol. Anesth Analg , 1992, 74(2): 246-249.
13. 15 Smith I, White PF, Nathanson M, et al . Propofol. An update on its clinical use. Anesthesiology , 1994, 81(4): 1005-1043.
14. 16 Ferreira SH. Peripheral analgesia: Mechanism of the analgesic action of aspirin-like drugs and opiate antagonists. Br J Clin Pkarmacol , 1980, 10(Suppl 2): 237S-244S.
15. 17 Auerswald K, Pfeiffer F, Behrends K, et al . Pain on injection with propofol. Anasthesiol Intensivmed Notfallmed Schmerzther , 2005, 40(5): 259-266.
16. 18 Ohmukai O. Lipo-NSAID preparation. Advanced Drug Delivery Reviews , 1996, 20(2-3): 203-207.
17. 20 Ochroch EA, Mardini IA, Gottschalk A. What is the role of NSAIDs in pre-emptive analgesia? Drugs , 2003, 63(24): 2709-2723.
18. 21 Tan CH, Onsiong MK. Pain on injection of propofol. Anaesthesia , 1998, 53(5): 468-476.
19. 馬玉姍, 林雪梅, 周俊. 格拉司瓊復合利多卡因減輕異丙酚注射痛的隨機雙盲對照研究. 四川大學學報, 2009, 40(3): 536-538.
20. Fleisher LA. Preoperative evaluation. In: Barash PG, Cullen BF, Stoelting RK, eds. Clinical Anesthesia. 3rd ed. Philadelphia, Pa: Lippincott-Raven, 1996: 443-459.
21. Insel PA. Analgesic-antipyretic and anti-inflammatory agents and drugs employed in the treatment of gout. In: Hardman JG, Limbird LE, Molinoff PB, Rudon RW, eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill; 1996: 617-657.

《中國循證醫學雜志》

氟比洛芬酯和利多卡因聯用緩解異丙酚注射痛的隨機對照研究

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《中國循證醫學雜志》

氟比洛芬酯和利多卡因聯用緩解異丙酚注射痛的隨機對照研究

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