Suzuki H, Miyazaki H, Andoh T, Yamada Y
Department of Anaesthesiology, Saiseikai Yokohamashi Nanbu Hospital, Kanagawa, Japan.
Acta Anaesthesiol Scand. 2006 May;50(5):568-71. doi: 10.1111/j.1399-6576.2006.00986.x.
Propofol is a widely used intravenous anesthetic although its injection pain is a common and unpleasant problem. Long-/medium-chain triglyceride (LCT/MCT) propofol has been introduced, as its low free propofol content is expected to reduce injection pain compared with LCT propofol. Target controlled infusion (TCI) differs from conventional induction in the initial infusion pattern. During induction using TCI, we investigated injection pain caused by two propofol solutions with different triglyceride compositions.
Fifty patients, ASA I-II, with adequate communicative ability, were randomly assigned to two groups. TCI was conducted with Diprifusor for LCT and with BeComSim (custom-made software) for LCT/MCT. The target blood concentration was set at 4 microg/ml for both groups. At 30, 60, and 120 s after the infusion, patients were asked questions regarding the severity of pain on a 0-10 pain score. The total dose of propofol and the time required to induce anesthesia were also investigated.
The LCT/MCT propofol group had a larger number of pain-free patients and showed lower severity of pain than the LCT group [the number of pain-free patients being 11 and 3, respectively (P < 0.05), and median maximum pain being 0 and 4.5, respectively (P < 0.01)]. The dose and time required for induction were not significantly different between the groups (dose of 84 +/- 27 and 80 +/- 24 mg, respectively, and time of 119 +/- 60 and 107 +/- 55 s, respectively).
Our study showed that the frequency and severity of pain during TCI induction with propofol could be significantly reduced using LCT/MCT propofol rather than LCT propofol.
丙泊酚是一种广泛使用的静脉麻醉剂，但其注射痛是一个常见且令人不适的问题。长链/中链甘油三酯（LCT/MCT）丙泊酚已被引入，因为其较低的游离丙泊酚含量预计与LCT丙泊酚相比可减轻注射痛。靶控输注（TCI）在初始输注模式上与传统诱导不同。在使用TCI诱导期间，我们研究了两种不同甘油三酯组成的丙泊酚溶液引起的注射痛。
50例ASA I-II级、具备充分沟通能力的患者被随机分为两组。使用Diprifusor进行LCT的TCI，使用BeComSim（定制软件）进行LCT/MCT的TCI。两组的靶血药浓度均设定为4微克/毫升。输注后30、60和120秒，询问患者关于疼痛严重程度的问题，采用0-10疼痛评分。还研究了丙泊酚的总剂量和诱导麻醉所需的时间。
LCT/MCT丙泊酚组无痛患者数量更多，且疼痛严重程度低于LCT组[无痛患者数量分别为11例和3例（P<0.05），最大疼痛中位数分别为0和4.5（P<0.01）]。两组之间诱导所需的剂量和时间无显著差异（剂量分别为84±27毫克和80±24毫克，时间分别为119±60秒和107±55秒）。
我们研究表明，与LCT丙泊酚相比，使用LCT/MCT丙泊酚可显著降低丙泊酚TCI诱导期间的疼痛频率和严重程度。
