Agarwal Anil, Ansari Mohammad F, Gupta Devendra, Pandey Ravindra, Raza Mehdi, Singh Prabhat K, Dhiraj Sanjay, Singh Uttam
Departments of Anesthesia and Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Anesth Analg. 2004 Mar;98(3):683-6, table of contents. doi: 10.1213/01.ane.0000103266.73568.18.
Propofol causes pain on IV injection in 28%-90% of patients. A number of techniques have been tried to minimize propofol-induced pain, with variable results. We compared the efficacy of pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg and lidocaine 40 mg after venous occlusion for prevention of propofol-induced pain. One-hundred-twenty-four adult patients, ASA physical status I-II, undergoing elective surgery were randomly assigned into 4 groups of 31 each. Group I received normal saline, group II received lidocaine 2% (40 mg), and groups III and IV received thiopental 0.25 mg/kg and 0.5 mg/kg, respectively. All pretreatment drugs were made in 2 mL and were accompanied by manual venous occlusion for 1 min. Propofol was administered after release of venous occlusion. Pain was assessed with a four-point scale: 0 = no pain, 1 = mild pain, 2 = moderate pain, and 3 = severe pain at the time of propofol injection. Twenty-four patients (77%) complained of pain in the group pretreated with normal saline as compared with 12 (39%), 10 (32%), and 1 (3%) in the groups pretreated with lidocaine 40 mg, thiopental 0.25 mg/kg, and thiopental 0.5 mg/kg, respectively (P < 0.05). Thiopental 0.5 mg/kg was the most effective treatment. We therefore suggest routine pretreatment with thiopental 0.5 mg/kg along with venous occlusion for 1 min for prevention of pain associated with propofol injection.
Pain associated with IV injection of propofol is seen in 28%-90% patients. Pretreatment with thiopental 0.25 mg/kg and 0.5 mg/kg after manual venous occlusion for 1 min effectively attenuated pain associated with propofol injection. Thiopental 0.5 mg/kg was the most effective in prevention of propofol pain and can be used routinely.
丙泊酚静脉注射时，28%-90%的患者会感到疼痛。人们尝试了多种技术来尽量减少丙泊酚引起的疼痛，但结果各异。我们比较了静脉闭塞后使用0.25mg/kg和0.5mg/kg硫喷妥钠以及40mg利多卡因预处理预防丙泊酚引起疼痛的效果。124例ASA身体状况为I-II级的成年择期手术患者被随机分为4组，每组31例。I组接受生理盐水，II组接受2%利多卡因（40mg），III组和IV组分别接受0.25mg/kg和0.5mg/kg硫喷妥钠。所有预处理药物均制成2ml，并伴有手动静脉闭塞1分钟。静脉闭塞解除后给予丙泊酚。采用四点量表评估疼痛：0=无疼痛，1=轻度疼痛，2=中度疼痛，3=丙泊酚注射时重度疼痛。生理盐水预处理组有24例患者（77%）主诉疼痛，而利多卡因40mg、0.25mg/kg硫喷妥钠和0.5mg/kg硫喷妥钠预处理组分别有12例（39%）、10例（32%）和1例（3%）主诉疼痛（P<0.05）。0.5mg/kg硫喷妥钠是最有效的治疗方法。因此，我们建议常规使用0.5mg/kg硫喷妥钠并结合静脉闭塞1分钟来预防丙泊酚注射相关的疼痛。
28%-90%的患者会出现丙泊酚静脉注射相关疼痛。手动静脉闭塞1分钟后使用0.25mg/kg和0.5mg/kg硫喷妥钠预处理可有效减轻丙泊酚注射相关疼痛。0.5mg/kg硫喷妥钠预防丙泊酚疼痛最有效，可常规使用。
