First Department of Anesthesiology, Toho University School of Medicine, Tokyo, Japan.
Minerva Anestesiol. 2011 Jul;77(7):693-7. Epub 2011 Mar 1.
Pain during the injection of propofol is a common clinical problem. Lidocaine pretreatment, preceded by venous occlusion, is the most popular method for reducing pain during the injection of propofol but cannot entirely control such pain. We aimed to evaluate the efficacy of lidocaine, flurbiprofen axetil (an injectable prodrug of flurbiprofen), and the two in combination for reducing pain during the injection of propofol.
This prospective, randomized, double-blind, placebo-controlled study was conducted at the Department of Anesthesiology, Ushiku Aiwa General Hospital, Ibaraki, Japan. One hundred patients, 55 men and 45 women aged 22-69 years old and with ASA physical statuses of I-II, were randomly allocated to one of four groups to receive intravenously placebo (saline), lidocaine 40 mg, flurbiprofen axetil 50 mg, or both (N=25 for each group), with venous occlusion for 2 minutes, followed by administration of propofol 0.5 mg/kg into a dorsal hand vein. A blind researcher asked the patients to assess pain during injection of propofol.
The treatment groups were comparable with respect to patient characteristics. The overall incidence of propofol-induced pain was 32% with lidocaine (P=0.001), 40% with flurbiprofen axetil (P = 0.001), and 8% with both (P=0.001), compared with 88% with placebo. The incidence of such pain was lower in patients receiving the lidocaine/flurbiprofen axetil combination than in those receiving lidocaine or flurbiprofen (P=0.036, combination vs. lidocaine; P=0.009, combination vs. flurbiprofen axetil).
The lidocaine/flurbiprofen axetil combination, compared with lidocaine 40 mg or flurbiprofen 50 mg, effectively reduces pain during the injection of propofol.
丙泊酚注射时疼痛是一个常见的临床问题。利多卡因预处理，继以静脉闭塞，是减轻丙泊酚注射疼痛的最常用方法，但不能完全控制这种疼痛。我们旨在评估利多卡因、氟比洛芬酯（氟比洛芬的注射前体药物）以及两者联合应用减轻丙泊酚注射疼痛的效果。
这是一项在日本茨城县牛久市的上岩井综合医院麻醉科进行的前瞻性、随机、双盲、安慰剂对照研究。100 名年龄在 22-69 岁之间的男性 55 名，女性 45 名，ASA 身体状况为 I-II 级的患者，随机分为四组，每组 25 名，分别静脉注射安慰剂（生理盐水）、利多卡因 40mg、氟比洛芬酯 50mg 或两者联合（每组 25 名），同时静脉闭塞 2 分钟，然后向手背静脉内注射 0.5mg/kg 丙泊酚。一位盲法研究人员询问患者注射丙泊酚时的疼痛情况。
治疗组患者的特征具有可比性。利多卡因组丙泊酚诱导疼痛的总发生率为 32%（P=0.001），氟比洛芬酯组为 40%（P=0.001），两者联合组为 8%（P=0.001），而安慰剂组为 88%。与单独使用利多卡因或氟比洛芬酯相比，接受利多卡因/氟比洛芬酯联合治疗的患者疼痛发生率较低（P=0.036，联合组与利多卡因组相比；P=0.009，联合组与氟比洛芬酯组相比）。
与 40mg 利多卡因或 50mg 氟比洛芬酯相比，利多卡因/氟比洛芬酯联合应用可有效减轻丙泊酚注射时的疼痛。
