Department of Anesthesiology and Intensive Care, G B Pant Hospital & Associated Maulana Azad Medical College, New Delhi, India.
J Anesth. 2013 Jun;27(3):402-6. doi: 10.1007/s00540-012-1533-0. Epub 2012 Dec 12.
Propofol injection is known to cause distressing pain, and various methods have been used to decrease this pain. We investigated the efficacy of the lidocaine + metoclopramide and lidocaine + ketamine combinations on modulating propofol injection pain.
Ninety ASA I/II patients aged 20-60 years were randomly assigned to three groups to receive lidocaine 20 mg (group L), lidocaine 20 mg + metoclopramide 10 mg (group LM), or lidocaine 20 mg + ketamine 5 mg (group LK), respectively, with venous occlusion for 1 min using a forearm tourniquet. Propofol 0.5 mg/kg was subsequently administered into a dorsal hand vein, and pain was assessed during its injection using a verbal rating score. The results were analyzed statistically with analysis of variance, the chi-square test, and the Wilcoxon rank sum test, where appropriate. The significance level was set at p < 0.05.
The incidence of pain was rated to be significantly less in patients in groups LM (40 %) and LK (6.7 %) than in those in group L (83.3 %) (p = 0.001 and p < 0.001, respectively). The pain score [median (range)] was also significantly less in patients in groups LM [0 (0-3)] and LK [0 (0-2)] than in those in group L [2 (0-3)] (p = 0.001 for both groups).
The lidocaine-ketamine combination is most effective for decreasing the pain on propofol injection.
众所周知，异丙酚注射会引起疼痛，已采用各种方法来减轻这种疼痛。我们研究了利多卡因+甲氧氯普胺和利多卡因+氯胺酮组合对调节异丙酚注射疼痛的疗效。
90 名 ASA I/II 级年龄在 20-60 岁的患者随机分为三组，分别接受利多卡因 20mg（组 L）、利多卡因 20mg+甲氧氯普胺 10mg（组 LM）或利多卡因 20mg+氯胺酮 5mg（组 LK），用前臂止血带对静脉进行 1 分钟的闭塞。随后在手背静脉内注入 0.5mg/kg 异丙酚，并在其注射过程中使用语言评分法评估疼痛。使用方差分析、卡方检验和 Wilcoxon 秩和检验对结果进行适当的统计分析，适当的统计分析。显著性水平设为 p<0.05。
组 LM（40%）和 LK（6.7%）患者的疼痛发生率明显低于组 L（83.3%）（p=0.001 和 p<0.001）。组 LM [0（0-3）]和 LK [0（0-2）]患者的疼痛评分[中位数（范围）]也明显低于组 L [2（0-3）]（两组均为 p=0.001）。
利多卡因-氯胺酮联合用药对降低异丙酚注射疼痛最有效。
