Necmettin Erbakan University, Meram School of Medicine, Department of Anesthesiology and Reanimation, Meram, Konya, Turkey.
Int J Med Sci. 2012;9(6):492-7. doi: 10.7150/ijms.4793. Epub 2012 Aug 15.
The pain on propofol injection is considered to be a common and difficult to eliminate problem in children. In this study, we aimed to compare the efficacy of pretreatment with tramadol 1 mg.kg(-1)and propofol-lidocaine 20 mg mixture for prevention of propofol induced pain in children.
One hundred and twenty ASA I-II patients undergoing orthopedic and otolaryngological surgery were included in this study and were divided into three groups with random table numbers. Group C (n=39) received normal saline placebo and Group T (n=40) received 1 mg.kg(-1) tramadol 60 sec before propofol (180 mg 1% propofol with 2 ml normal saline) whereas Group L (n=40) received normal saline placebo before propofol-lidocaine mixture (180 mg 1% propofol with 2 ml %1 lidocaine). One patient in Group C was dropped out from the study because of difficulty in inserting an iv cannula. Thus, one hundred and nineteen patients were analyzed for the study. After given the calculated dose of propofol, a blinded observer assessed the pain with a four-point behavioral scale.
There were no significant differences in patient characteristics and intraoperative variables (p>0.05) except intraoperative fentanyl consumption and analgesic requirement one hr after surgery among the groups (p<0.05). Both tramadol 1 mg.kg(-1) and lidocaine 20 mg mixture significantly reduced propofol pain when compared with control group. Moderate and severe pain were found higher in control group (p<0.05). The incidence of overall pain was 79.4% in the control group, 35% in tramadol group, 25% in lidocaine group respectively (p<0.001).
Pretreatment with tramadol 60 sec before propofol injection and propofol-lidocaine mixture were significantly reduced propofol injection pain when compared to placebo in children.
在儿童中，异丙酚注射引起的疼痛被认为是一个常见且难以消除的问题。在这项研究中，我们旨在比较曲马多 1mg/kg(-1)和异丙酚-利多卡因 20mg 混合物预处理预防儿童异丙酚诱导疼痛的效果。
本研究纳入 120 例 ASA I-II 级择期行骨科和耳鼻喉科手术的患儿，采用随机数字表法将其分为三组。C 组（n=39）给予生理盐水安慰剂，T 组（n=40）给予异丙酚（180mg 1%异丙酚加 2ml 生理盐水）前 60 秒给予 1mg/kg(-1)曲马多，L 组（n=40）给予生理盐水安慰剂，然后给予异丙酚-利多卡因混合物（180mg 1%异丙酚加 2ml%1 利多卡因）。由于静脉穿刺困难，C 组有 1 例患儿退出研究。因此，共有 119 例患儿纳入研究。给予计算剂量的异丙酚后，一名盲法观察者采用四点行为量表评估疼痛。
三组患儿的一般资料和术中变量无显著差异（p>0.05），但术中芬太尼用量和术后 1 小时的镇痛需求存在差异（p<0.05）。与对照组相比，曲马多 1mg/kg(-1)和利多卡因 20mg 混合物均能显著减轻异丙酚引起的疼痛。对照组中中重度疼痛发生率较高（p<0.05）。对照组总疼痛发生率为 79.4%，曲马多组为 35%，利多卡因组为 25%（p<0.001）。
与安慰剂相比，异丙酚注射前 60 秒给予曲马多和异丙酚-利多卡因混合物预处理可显著减轻儿童异丙酚注射疼痛。
