Yavascaoglu Belgin, Kaya Fatma Nur, Ozcan Berin
Department of Anesthesiology and Reanimation, Uludag University Medical School, Bursa, Turkey.
J Clin Anesth. 2007 Sep;19(6):413-7. doi: 10.1016/j.jclinane.2007.02.011.
To determine the effect of esmolol on the frequency and severity of pain and withdrawal reactions after injection of rocuronium and to compare it with lidocaine and placebo.
Prospective, randomized, double-blind, placebo-controlled study.
Single university hospital.
120 ASA physical status I and II patients undergoing general anesthesia for elective surgery.
Patients were randomized to receive esmolol (0.5 mg/kg), lidocaine (0.5 mg/kg), or placebo, followed by a subparalyzing dose of rocuronium. After induction of anesthesia with propofol and fentanyl, an intubating dose of rocuronium 0.6 mg/kg was given.
Patients were observed after injection of rocuronium 0.05 mg/kg, then immediately asked if they had pain in the arm. The response was assessed; discomfort, pain, and withdrawal of the hand were recorded and graded using a 4-point scale (none, mild, moderate, or severe). After the intubating dose of rocuronium, withdrawal reactions were scored as follows: (a) no pain response, (b) pain limited to the wrist, (c) pain limited to the elbow/shoulder, or (d) generalized pain response.
31 patients (77.5%) in the esmolol group, 32 (80%) in the lidocaine group, and 15 (37.5%) in the placebo group reported no pain (both groups vs placebo, P < 0.001). Moderate pain was seen in only one patient receiving lidocaine, in 6 placebo patients, but in none in the esmolol group (esmolol vs placebo, P < 0.05). Severe pain was felt by 8 patients receiving placebo, but by none receiving esmolol or lidocaine (P < 0.01). Frequency of withdrawal response after rocuronium was 2.5%, 17.5%, and 40% in the esmolol, lidocaine, and placebo groups, respectively (esmolol group vs placebo, P < 0.001; lidocaine group vs placebo, P < 0.05).
Esmolol, like lidocaine, reduces the frequency of pain and withdrawal reaction associated with rocuronium injection.
确定艾司洛尔对注射罗库溴铵后疼痛频率及严重程度和退缩反应的影响,并将其与利多卡因及安慰剂进行比较。
前瞻性、随机、双盲、安慰剂对照研究。
单一大学医院。
120例美国麻醉医师协会(ASA)身体状况为Ⅰ级和Ⅱ级、接受择期手术全身麻醉的患者。
患者被随机分为接受艾司洛尔(0.5mg/kg)、利多卡因(0.5mg/kg)或安慰剂,随后给予亚麻痹剂量的罗库溴铵。在用丙泊酚和芬太尼诱导麻醉后,给予0.6mg/kg的插管剂量罗库溴铵。
注射0.05mg/kg罗库溴铵后观察患者,然后立即询问其手臂是否疼痛。评估回答情况;记录手部的不适、疼痛及退缩情况,并使用4分制(无、轻度、中度或重度)进行分级。给予插管剂量的罗库溴铵后,退缩反应评分如下:(a)无疼痛反应,(b)疼痛局限于手腕,(c)疼痛局限于肘部/肩部,或(d)全身性疼痛反应。
艾司洛尔组31例患者(77.5%)、利多卡因组32例患者(80%)和安慰剂组15例患者(37.5%)报告无疼痛(两组与安慰剂组比较,P<0.001)。仅1例接受利多卡因的患者、6例接受安慰剂的患者出现中度疼痛,但艾司洛尔组无患者出现中度疼痛(艾司洛尔组与安慰剂组比较,P<0.05)。8例接受安慰剂的患者感到重度疼痛,但接受艾司洛尔或利多卡因的患者均无此情况(P<0.01)。罗库溴铵注射后,艾司洛尔组、利多卡因组和安慰剂组的退缩反应频率分别为2.5%、17.5%和40%(艾司洛尔组与安慰剂组比较,P<0.001;利多卡因组与安慰剂组比较,P<0.05)。
与利多卡因一样,艾司洛尔可降低与罗库溴铵注射相关的疼痛频率和退缩反应。