Apiliogullari S, Keles B, Apiliogullari B, Balasar M, Yilmaz H, Duman A
Ozel Konya Hospital, Department of Anaesthesia and Intensive Care, Turkey.
Eur J Anaesthesiol. 2007 Mar;24(3):235-8. doi: 10.1017/S026502150600202X. Epub 2007 Jan 4.
Pain on injection is still a problem with propofol. The purpose of the study was to compare the effectiveness of diphenhydramine and lidocaine on pain caused by propofol at the site of injection.
One hundred and eighty ASA I-II adults undergoing elective surgery were randomly assigned into three groups of 60 each. Group I (placebo) received 2 mL normal saline, Group II received 2 mL (40 mg) 2% lidocaine and Group III received 2 mL (20 mg) diphenhydramine intravenously (i.v.) during a 1-min venous occlusion, followed by propofol into a cephalic forearm vein of the antecubital fossa. Pain assessment was made immediately after propofol injection.
In the placebo group 25 (41.7%) patients experienced pain during propofol injection as compared to 2 (3.3%) and 3 (5.0%) in the lidocaine and diphenhydramine groups, respectively. The prevalence of pain and pain score were significantly less in both the lidocaine and diphenhydramine groups than in the placebo group (P = 0.00). No difference was found between the diphenhydramine and lidocaine groups (P = 0.60).
Previous injection of diphenhydramine with venous occlusion can be considered as an alternative to lidocaine for reducing the prevalence of pain caused by injection of propofol into peripheral veins.
丙泊酚注射时疼痛仍是一个问题。本研究的目的是比较苯海拉明和利多卡因对丙泊酚注射部位疼痛的缓解效果。
180例接受择期手术的ASA I-II级成年患者被随机分为三组，每组60例。第一组（安慰剂组）静脉注射2ml生理盐水，第二组静脉注射2ml（40mg）2%利多卡因，第三组在1分钟静脉阻断期间静脉注射2ml（20mg）苯海拉明，随后将丙泊酚注入肘前窝的头静脉。丙泊酚注射后立即进行疼痛评估。
安慰剂组25例（41.7%）患者在丙泊酚注射时出现疼痛，利多卡因组和苯海拉明组分别为2例（3.3%）和3例（5.0%）。利多卡因组和苯海拉明组的疼痛发生率和疼痛评分均显著低于安慰剂组（P = 0.00）。苯海拉明组和利多卡因组之间无差异（P = 0.60）。
静脉阻断时预先注射苯海拉明可作为利多卡因的替代方法，以降低丙泊酚外周静脉注射所致疼痛的发生率。
