Yeo Jinseok, Jeon Younghoon, Kim Youngsoo, Ha Jaehyun, Baek Woonyi
Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Curr Ther Res Clin Exp. 2009 Oct;70(5):351-8. doi: 10.1016/j.curtheres.2009.10.001.
Pain on injection of propofol is a common adverse event.
The aim of this study was to investigate the effect of a combination of ketorolac pretreatment and premixed lidocaine in propofol compared with placebo on propofol injection pain.
In this prospective, randomized, double-blind, placebo-controlled study, Korean patients scheduled for elective plastic surgery were randomized to 1 of 3 groups. Group A received 15 mg ketorolac in saline IV as pretreatment. Groups B and C received 3 mL saline IV as pretreatment. Sixty seconds after pretreatment, groups A and B received a mixture of lidocaine 1% in propofol 1% at a 1:10 ratio and group C received propofol 1% alone. Pain during propofol injection was assessed on a 4-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe).
Ninety patients (41 men, 49 vvomen; mean age, 41.7 years; mean weight, 63 kg) completed the study. The overall incidence of pain on propofol injection was significantly lower in groups A (16.7%) and B (36.7%) than in group C (83.3%; both, P < 0.001). There was no significant difference in the incidence of pain between groups A and B. However, the patients in group A reported a significantly lower incidence of moderate (0% vs 33.3%; P < 0.001) and severe pain (0% vs 20%; P = 0.024) compared with those in group C. There were no significant differences in the incidences of moderate and severe pain between the B and C groups.
In this Korean population, premixed lidocaine in propofol with or without ketorolac pretreatment was associated with significantly less pain when compared with placebo. The combination of ketorolac pretreatment and premixed lidocaine in propofol was more effective in decreasing the incidence of moderate or severe pain compared with placebo.
丙泊酚注射痛是一种常见的不良事件。
本研究旨在探讨酮咯酸预处理联合预混利多卡因的丙泊酚与安慰剂相比对丙泊酚注射痛的影响。
在这项前瞻性、随机、双盲、安慰剂对照研究中，计划进行择期整形手术的韩国患者被随机分为3组中的1组。A组静脉注射15mg酮咯酸生理盐水作为预处理。B组和C组静脉注射3mL生理盐水作为预处理。预处理60秒后，A组和B组接受1%利多卡因与1%丙泊酚按1:10比例混合的溶液，C组仅接受1%丙泊酚。丙泊酚注射期间的疼痛采用4级评分法评估（0 = 无，1 = 轻度，2 = 中度，3 = 重度）。
90例患者（41例男性，49例女性；平均年龄41.7岁；平均体重63kg）完成了研究。丙泊酚注射痛的总体发生率在A组（16.7%）和B组（36.7%）显著低于C组（83.3%；P均<0.001）。A组和B组之间的疼痛发生率无显著差异。然而，与C组相比，A组患者中度疼痛（0%对33.3%；P<0.001）和重度疼痛（0%对20%；P = 0.024）的发生率显著更低。B组和C组之间中度和重度疼痛的发生率无显著差异。
在该韩国人群中，与安慰剂相比，含或不含酮咯酸预处理的预混利多卡因丙泊酚引起的疼痛明显更少。与安慰剂相比，酮咯酸预处理联合预混利多卡因丙泊酚在降低中度或重度疼痛发生率方面更有效。
