Department of Anaesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba City, Ibaraki, Japan.
Clin Drug Investig. 2004;24(12):749-53. doi: 10.2165/00044011-200424120-00006.
Pain is a well recognised complication of propofol injection. The purpose of this study was to compare the efficacy of flurbiprofen, lidocaine and a combination of the two in reducing pain on injection of propofol.
Prospective, randomised, double-blind, placebo-controlled study.
University hospital in Tsukuba City, Japan.
120 patients, 56 males and 64 females, aged 20-66 years, scheduled for elective plastic surgery were included. Patients received intravenously either lidocaine 20mg, flurbiprofen 50mg, both, or placebo (saline) accompanied by manual venous occlusion for 2 minutes, followed by administration of propofol 2 mg/kg into a dorsal hand vein (n = 30 in each group). A blinded researcher asked each patient to evaluate the pain score (0 = none, 1 = mild, 2 = moderate, 3 = severe) during propofol injection.
The incidence and intensity of pain was less in patients receiving lidocaine (27%, pain score 0 [median]), flurbiprofen (43%, 0), or both (3%, 0) along with venous occlusion than in those receiving placebo (90%, 2) along with venous occlusion (p < 0.01). Combined lidocaine and flurbiprofen with venous occlusion was the most effective treatment (p < 0.05). No complications such as pain, oedema, wheal or flare response were observed at the injection sites within the first 24 hours after surgery.
Combined lidocaine 20mg and flurbiprofen 50mg along with venous occlusion for 2 minutes was very effective for reducing pain on injection of propofol in patients scheduled for elective plastic surgery.
疼痛是丙泊酚注射的一种公认并发症。本研究旨在比较氟比洛芬、利多卡因以及两者联合在减轻丙泊酚注射疼痛方面的效果。
前瞻性、随机、双盲、安慰剂对照研究。
日本筑波市的一所大学医院。
120 名年龄在 20-66 岁之间、择期行整形手术的患者被纳入本研究。患者静脉内接受利多卡因 20mg、氟比洛芬 50mg、两者联合或安慰剂（生理盐水），同时进行 2 分钟的手动静脉闭塞，随后在手背静脉内给予丙泊酚 2mg/kg。一位盲法研究者要求每位患者在丙泊酚注射期间评估疼痛评分（0=无，1=轻度，2=中度，3=重度）。
接受利多卡因（27%，疼痛评分为 0[中位数]）、氟比洛芬（43%，0）或两者联合（3%，0）并进行静脉闭塞的患者的疼痛发生率和强度均低于接受安慰剂（90%，2）并进行静脉闭塞的患者（p<0.01）。联合应用利多卡因和氟比洛芬并进行静脉闭塞是最有效的治疗方法（p<0.05）。术后 24 小时内，注射部位未观察到疼痛、水肿、风团或红斑反应等并发症。
在择期行整形手术的患者中，联合应用 20mg 利多卡因和 50mg 氟比洛芬并进行 2 分钟的静脉闭塞非常有效地减轻了丙泊酚注射时的疼痛。
