Seki S, Sekine R, Aketa K, Kobayashi Y, Ichimiya T, Tsuchida H, Namiki A
Department of Anesthesia, Asahikawa City Hospital.
Masui. 1999 Jan;48(1):62-6.
We compared propofol injected through a central venous catheter with that through a peripheral cannula from the standpoint of injection pain, induction time and hemodynamic changes. Thirty-nine patients about to receive abdominal surgery, who had central venous catheters inserted via the subclavian vein, were included in this study. General anesthesia was induced with a loading dose of propofol 1 mg.kg-1 followed by an infusion of 10 mg.kg-1.hr-1 into the central vein without carrier intravenous fluid (group A, n = 13), the peripheral vein without carrier intravenous fluid (group B, n = 13) or the peripheral vein with rapid infusion of acetated Ringer's solution (group C, n = 13). After endotracheal intubation, anesthesia was maintained with propofol 4 mg.kg-1.hr-1. The incidence of injection pain was 53% in group B and 76% in group C, whereas none of the patients in group A felt discomfort or pain during propofol injection. The mean induction time was significantly shorter in group A (43 +/- 12 sec) than group B (66 +/- 16 sec) or group C (57 +/- 11 sec). There were no differences between each group in hemodynamic changes during induction of anesthesia. Propofol injection via central venous catheter can avoid the injection pain and shorten the induction time.
我们从注射疼痛、诱导时间和血流动力学变化的角度,比较了通过中心静脉导管注射丙泊酚与通过外周套管注射丙泊酚的情况。本研究纳入了39例即将接受腹部手术且已通过锁骨下静脉插入中心静脉导管的患者。采用1mg·kg-1的丙泊酚负荷剂量诱导全身麻醉,随后分别向中心静脉(A组,n = 13)、外周静脉且不使用载体静脉输液(B组,n = 13)或外周静脉且快速输注醋酸林格液(C组,n = 13)以10mg·kg-1·hr-1的速度输注丙泊酚。气管插管后,用4mg·kg-1·hr-1的丙泊酚维持麻醉。B组注射疼痛发生率为53%,C组为76%,而A组患者在注射丙泊酚期间均未感到不适或疼痛。A组的平均诱导时间(43±12秒)明显短于B组(66±16秒)或C组(57±11秒)。麻醉诱导期间各组的血流动力学变化无差异。通过中心静脉导管注射丙泊酚可避免注射疼痛并缩短诱导时间。