Moon Young Eun, Lee Michael Y, Kim Dong Hyun
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
Department of Physical Medicine and Rehabilitation, Memorial Hospital, College of Medicine, The University of North Carolina, Chapel Hill, USA.
J Anesth. 2017 Oct;31(5):703-708. doi: 10.1007/s00540-017-2386-3. Epub 2017 Aug 5.
Propofol causes injection pain. Although lidocaine pre-treatment via venous occlusion is known to be the most effective way, it still has some inconvenience. We implemented this study to compare the effect of a vapocoolant spray with lidocaine pre-treatment.
Participants (n = 90) were randomized to one of three groups. Group V: after placebo injection and tourniquet, the vapocoolant spray was applied; group L: after lidocaine injection and tourniquet, the placebo spray was applied; group C: after placebo injection and tourniquet, the placebo spray was applied. The intensity of propofol-induced pain, the incidence of metallic taste, and the satisfaction were assessed.
Propofol-induced pain was significantly lower in groups V and L than in group C [0.5 (0-2.25), 0.5 (0-1), and 5 (1-7), median (interquartile range), respectively, p < 0.001]. There was no significant difference in pain intensity between groups V and L. Group L showed a significantly higher incidence of metallic taste than groups V and C (23, 0, and 0%, respectively; p = 0.001). Groups V and L showed higher satisfaction scores than group C [5 (4-5), 4 (3.75-5), and 2 (2-3), respectively; p < 0.001], and there was a significant difference between groups V and L (p = 0.012).
Vapocoolant spray showed a similar effect to lidocaine in analgesia and lowered the incidence of a metallic taste. These resulted in greater satisfaction with the vapocoolant spray compared with lidocaine. Vapocoolant spray is an effective and convenient way to prevent propofol-induced pain.
丙泊酚会引起注射痛。虽然通过静脉闭塞进行利多卡因预处理是已知最有效的方法，但仍存在一些不便之处。我们开展本研究以比较冷感喷雾剂与利多卡因预处理的效果。
参与者（n = 90）被随机分为三组之一。V组：在注射安慰剂并使用止血带后，应用冷感喷雾剂；L组：在注射利多卡因并使用止血带后，应用安慰剂喷雾剂；C组：在注射安慰剂并使用止血带后，应用安慰剂喷雾剂。评估丙泊酚所致疼痛的强度、金属味的发生率及满意度。
V组和L组丙泊酚所致疼痛明显低于C组[分别为0.5（0 - 2.25）、0.5（0 - 1）和5（1 - 7），中位数（四分位间距），p < 0.001]。V组和L组之间疼痛强度无显著差异。L组金属味的发生率明显高于V组和C组（分别为23%、0%和0%；p = 0.001）。V组和L组的满意度得分高于C组[分别为5（4 - 5）、4（3.75 - 5）和2（2 - 3）；p < 0.001]，且V组和L组之间存在显著差异（p = 0.012）。
冷感喷雾剂在镇痛方面显示出与利多卡因相似的效果，并降低了金属味的发生率。与利多卡因相比，这些结果使对冷感喷雾剂的满意度更高。冷感喷雾剂是预防丙泊酚所致疼痛的一种有效且便捷的方法。
