Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98111, USA.
Reg Anesth Pain Med. 2011 Jan-Feb;36(1):41-5. doi: 10.1097/AAP.0b013e31820306da.
Findings from studies investigating optimal techniques for attenuating propofol-related injection pain are inconsistent. In previous studies, lidocaine pretreatment using a tourniquet has been reported to be superior, inferior, or equivalent to a lidocaine-propofol admixture for reducing pain. This discordance could represent either no meaningful difference in the treatments or underlying methodological differences in the previous studies. We hypothesized that tourniquet-controlled pretreatment with lidocaine would be superior to lidocaine-propofol admixture for reducing propofol injection pain.
This randomized controlled trial compared 3 groups-a control group (saline pretreatment/saline admixture; n = 50), a pretreatment group (lidocaine pretreatment/saline admixture; n = 51), and an admixture group (saline pretreatment/lidocaine admixture; n = 50). The primary outcome was verbal pain score after injection. The incidence of pain on injection was explored as a secondary outcome.
The median (interquartile range) verbal pain score after study solution injection were as follows-control group: 3 (0-6), pretreatment group: 0 (0-0), and admixture group: 0 (0-2). The pretreatment group had significantly lower pain scores when compared with the admixture group (P = 0.016), and both groups were superior to the control group. The pretreatment group had fewer subjects experiencing any injection pain than did the admixture group (20% vs. 44%, respectively; P = 0.024).
Tourniquet-controlled pretreatment with lidocaine is statistically superior to admixing lidocaine with propofol for reducing propofol injection pain intensity, but the clinical importance of this small effect is questionable. However, pretreatment more effectively eliminates injection pain.
研究减轻异丙酚相关注射痛的最佳技术的研究结果不一致。在以前的研究中，已报道使用止血带进行利多卡因预处理优于利多卡因-丙泊酚混合物，可减轻疼痛。这种不一致可能代表两种治疗方法之间没有实质性差异，也可能代表以前研究中的方法学差异。我们假设使用止血带控制利多卡因预处理将优于利多卡因-丙泊酚混合物，以减轻异丙酚注射痛。
这是一项随机对照试验，比较了 3 组-对照组（生理盐水预处理/生理盐水混合物；n = 50）、预处理组（利多卡因预处理/生理盐水混合物；n = 51）和混合物组（生理盐水预处理/利多卡因混合物；n = 50）。主要结局是注射后言语疼痛评分。次要结局是探讨注射时疼痛的发生率。
研究溶液注射后中位数（四分位距）言语疼痛评分如下-对照组：3（0-6），预处理组：0（0-0），混合物组：0（0-2）。与混合物组相比，预处理组的疼痛评分明显较低（P = 0.016），且两组均优于对照组。与混合物组相比，预处理组有更少的患者经历任何注射疼痛（分别为 20%和 44%；P = 0.024）。
使用止血带控制利多卡因预处理在统计学上优于将利多卡因与丙泊酚混合，以减轻异丙酚注射疼痛强度，但这种小效应的临床重要性值得怀疑。然而，预处理更有效地消除了注射疼痛。
