Pollard Rachel C, Makky Sonia, McFadzean Jillian, Ainsworth Laurie, Goobie Susan M, Montgomery Carolyne J
Department of Anesthesia, British Columbia's Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada.
Can J Anaesth. 2002 Dec;49(10):1064-9. doi: 10.1007/BF03017904.
To evaluate the incidence of pain on injection in children during anesthetic induction with a 3:1.2 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lidocaine (P/L).
After Ethics Committee approval and informed written parental consent, 127 children, aged one to ten years were studied and randomized into two groups; Group P/L received an induction with 5 mg x kg(-1) of 1% propofol and 1 mg x kg(-1) of lidocaine, Group P/T with 3 mg x kg(-1) of 1% propofol and 3 mg x kg(-1) of 2.5% thiopentone in a standardized fashion. A single, blinded observer scored pain behaviour defined as a motor response of the arm, a verbal complaint of pain, cry and/or one of three standardized facial expressions of pain.
The incidence of pain was 14% in the P/T group, compared to 35% in the P/L group (chi(2)(1) = 7.5, P = 0.006). Motor response was the most frequent pain response in the P/L group (68%).
The P/T admixture is a practical and efficacious alternative to P/L for reducing pain on induction in children. Further work to evaluate the optimum proportions and possible adverse effects of this admixture should be done.
评估在儿童麻醉诱导期间，与1%丙泊酚和2%利多卡因按10:1体积混合液（P/L）相比，1%丙泊酚和2.5%硫喷妥钠按3:1.2体积混合液（P/T）注射时疼痛的发生率。
经伦理委员会批准并获得家长书面知情同意后，对127名年龄在1至10岁的儿童进行研究，并随机分为两组；P/L组以标准化方式接受5mg/kg-1的1%丙泊酚和1mg/kg-1的利多卡因诱导，P/T组接受3mg/kg-1的1%丙泊酚和3mg/kg-1的2.5%硫喷妥钠诱导。由一名单盲观察者对疼痛行为进行评分，疼痛行为定义为手臂的运动反应、疼痛的口头主诉、哭泣和/或三种标准化疼痛面部表情之一。
P/T组疼痛发生率为14%，而P/L组为35%（χ(2)(1)=7.5，P=0.006）。运动反应是P/L组最常见的疼痛反应（68%）。
P/T混合液是一种实用且有效的替代P/L混合液的方法，可减少儿童诱导期的疼痛。应进一步开展工作，评估该混合液的最佳比例及可能的不良反应。
