Banu Parvin, Biswas Arunava, Naser Syed Mohammed, Ghosh Sujata, Ghosh Kakoli, Mandal Sangita
Assistant Professor, Department of Anaesthesiology, Calcutta National Medical College, Kolkata, West Bengal, India.
Assistant Professor, Department of Pharmacology, Calcutta National Medical College, Kolkata, West Bengal, India.
J Clin Diagn Res. 2017 Aug;11(8):UC09-UC12. doi: 10.7860/JCDR/2017/29503.10489. Epub 2017 Aug 1.
Pain during propofol injection is a very commonly and frequently encountered event during induction of anaesthesia. A 5HT3 antagonists like granisetron are commonly used just prior to intravenous propofol as pre anaesthetic medication to prevent emesis in patients.
Comparison of pre treatment with granisetron versus lignocaine with respect to amelioration of pain induced by injection of propofol, in patient admitted for elective surgery with general anaesthesia.
A randomized double blinded controlled study was conducted with patients divided into three groups with (n=30) in each group. Group I (the placebo group) received 2 ml of 0.9% normal saline, Group II received 2 ml of 1% lignocaine and Group III received 2 ml of granisetron (1 mg/ml) as pre treatment medication respectively. The patient's complain regarding pain on intravenous propofol administration was recorded using the Verbal Rating Score. Pulse, BP, SpO were noted meticulously on three occasions-immediately after pre-treatment, injecting full dose of propofol (not for pain assessment) and after 10 minutes. The results were analysed using the null hypothesis and two sample t-tests.
It was observed and obvious that the relief of pain was significant (p<0.05) when granisetron or lignocaine was compared with the placebo group. But there was insignificant difference (p>0.05) when granisetron was compared with lignocaine in terms of relieve of pain induced by propofol.
It was concluded that parenteral administration of granisetron can be considered to be superior to lignocaine as pre treatment medication for pain relief after propofol injection along with the advantage of its anti-emetic effect.
异丙酚注射时的疼痛是麻醉诱导过程中非常常见且频繁遇到的情况。5-羟色胺3（5HT3）拮抗剂如格拉司琼，常在静脉注射异丙酚前作为麻醉前用药，以预防患者呕吐。
比较格拉司琼与利多卡因预处理对全身麻醉下行择期手术患者异丙酚注射所致疼痛的缓解作用。
进行一项随机双盲对照研究，将患者分为三组，每组30例。第一组（安慰剂组）接受2 ml 0.9%生理盐水，第二组接受2 ml 1%利多卡因，第三组接受2 ml格拉司琼（1 mg/ml）作为预处理药物。使用视觉模拟评分法记录患者静脉注射异丙酚时的疼痛主诉。在预处理后、注射全量异丙酚（非用于疼痛评估）后及10分钟后这三个时间点，仔细记录脉搏、血压、血氧饱和度。结果采用无效假设和两样本t检验进行分析。
观察发现，格拉司琼或利多卡因与安慰剂组相比，疼痛缓解具有显著意义（p<0.05）。但在缓解异丙酚所致疼痛方面，格拉司琼与利多卡因相比差异无统计学意义（p>0.05）。
得出结论，静脉注射格拉司琼作为异丙酚注射后疼痛缓解的预处理药物，可被认为优于利多卡因，且具有抗呕吐作用。
