Bano Fauzia, Zafar Safia, Sabbar Salim, Aftab Sadqa, Haider Saeeda, Sultan S T
Department of Anesthesia, St. Vincent's University Hospital, Dublin, Republic of Ireland.
J Coll Physicians Surg Pak. 2007 Jul;17(7):390-3.
To compare the effects of lidocaine and ketamine pretreatment on injection pain and hypotension due to propofol induction.
Double blinded randomized controlled clinical trial. Place and Duration of the Study: Department of Anesthesiology, Surgical Intensive Care Unit and Pain Management, Dow University of Health Sciences and Civil Hospital, Karachi from February 2005 to December 2005.
One hundred patients, age 20-60 years, of either gender, ASA I and II scheduled for elective gynaecological, urological, orthopedic or general surgical procedures under general anesthesia were randomly allocated into two groups i.e. group A to receive ketamine 0.5 mg/kg in volume of 2 ml with venous occlusion and group B to receive 2 ml of 1% lidocaine with venous occlusion as pretreatment before propofol induction. Venous occlusion was performed using rubber tourniquet after elevating the arm for 30 seconds, which was released 60 seconds after giving the pretreatment bolus and anesthesia was induced with propofol (2 mg/ml). Fifteen seconds after injection of 25%, the calculated dose of propofol and severity of injection pain was evaluated. Heart rate (HR) and noninvasive blood pressure were recorded pre-operatively, just before propofol induction, after propofol induction, immediately after intubation and 3 minutes after intubation.
Comparing the lidocaine group, the intensity and incidence of pain after propofol injection was lower in ketamine group but remained statistically insignificant. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher in ketamine group after induction with propofol. The maximum fall in SBP from baseline in ketamine group was 16% and 29.1% in lidocaine group, while maximum decrease in DBP in ketamine group was found to be12.66% vs. 26.47% in lidocaine group. There was no significant change in heart rate from baseline in either group.
Ketamine pre-treatment with venous occlusion is an effective method in reducing pain and providing hemodynamic stability after propofol induction.
比较利多卡因和氯胺酮预处理对丙泊酚诱导所致注射痛和低血压的影响。
双盲随机对照临床试验。研究地点和时间：2005年2月至2005年12月，卡拉奇道健康科学大学和市民医院麻醉科、外科重症监护室及疼痛管理科。
100例年龄20 - 60岁、性别不限、ASA I级和II级、计划在全身麻醉下进行择期妇科、泌尿外科、骨科或普通外科手术的患者，随机分为两组，即A组在静脉阻断情况下接受2ml含0.5mg/kg氯胺酮，B组在丙泊酚诱导前在静脉阻断情况下接受2ml 1%利多卡因作为预处理。在抬高上肢30秒后使用橡胶止血带进行静脉阻断，在给予预处理推注后60秒松开，然后用丙泊酚（2mg/ml）诱导麻醉。注射25%计算剂量的丙泊酚后15秒，评估注射痛强度。术前、丙泊酚诱导前、丙泊酚诱导后、插管后即刻及插管后3分钟记录心率（HR）和无创血压。
与利多卡因组相比，氯胺酮组丙泊酚注射后的疼痛强度和发生率较低，但无统计学意义。丙泊酚诱导后氯胺酮组收缩压（SBP）和舒张压（DBP）显著更高。氯胺酮组SBP较基线的最大降幅为16%，利多卡因组为29.1%；氯胺酮组DBP的最大降幅为12.66%，利多卡因组为26.47%。两组心率较基线均无显著变化。
静脉阻断下氯胺酮预处理是减轻丙泊酚诱导后疼痛并提供血流动力学稳定性的有效方法。
