Adinehmehr Leili, Salimi Sohrab, Sane Shahryar, Sina Venous, Najafizadeh Rana
Department of Anesthesiology, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of General Anesthesiology, Imam Hossein General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Adv Biomed Res. 2018 Apr 25;7:74. doi: 10.4103/abr.abr_186_17. eCollection 2018.
The incidence of propofol injection pain during induction of general anesthesia varies from 28% to 90%. This prospective, randomized, double-blind, placebo-controlled study evaluated the effect of dexamethasone and granisetron for reducing the incidence and severity of propofol injection pain.
A total of 227 female subjects received 5 mL of preservative-free saline, 1 mg granisetron (5 ml), or 0.15 mg/kg of dexamethasone (5 ml), intravenously, following exsanguination and occlusion of the veins of the arm. This was followed by a 0.5 mg/kg injection of propofol. Pain scores and intensity of pain recorded immediately following the injection of propofol. Hemodynamic parameters and O sat were recorded 1, 3, 5, and 10 min after propofol injection.
The incidence pain following the injection of propofol was significantly decreased with both granisetron and dexamethasone (50.7% and 49.4%). Mean pain score in granisetron group was 3.16 ± 1.23, dexamethasone was 2.73 ± 1.03, and in saline group was 4.82 ± 1.73 ( = 0.001). Mean pain intensity in granisetron group was 1.16 ± 0.18, dexamethasone was 1.26 ± 0.14, and in saline group was 2.2 ± 0.99 ( = 0.001). There were no differences in either mean arterial pressure or O Sate at any time point after drugs injection among the groups. There was a significant difference in pulse rate in third minutes between three groups and in the group who received granisetron was lesser ( = 0.04).
Pretreatment with intravenous granisetron (1 mg) and dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain due to propofol injection.
全身麻醉诱导期间丙泊酚注射痛的发生率在28%至90%之间。这项前瞻性、随机、双盲、安慰剂对照研究评估了地塞米松和格拉司琼对降低丙泊酚注射痛的发生率和严重程度的效果。
总共227名女性受试者在手臂静脉放血和阻断后,静脉注射5毫升无防腐剂生理盐水、1毫克格拉司琼(5毫升)或0.15毫克/千克地塞米松(5毫升)。随后注射0.5毫克/千克丙泊酚。在注射丙泊酚后立即记录疼痛评分和疼痛强度。在丙泊酚注射后1、3、5和10分钟记录血流动力学参数和血氧饱和度。
格拉司琼和地塞米松均可显著降低丙泊酚注射后的疼痛发生率(分别为50.7%和49.4%)。格拉司琼组的平均疼痛评分为3.16±1.23,地塞米松组为2.73±1.03,生理盐水组为4.82±1.73(P = 0.001)。格拉司琼组的平均疼痛强度为1.16±0.18,地塞米松组为1.26±0.14,生理盐水组为2.2±0.99(P = 0.001)。各药物注射后任何时间点的平均动脉压或血氧饱和度在各组间均无差异。三组在第3分钟时的脉搏率有显著差异,格拉司琼组较低(P = 0.04)。
在注射丙泊酚前静脉注射格拉司琼(1毫克)和地塞米松(0.15毫克/千克)预处理,在降低丙泊酚注射所致疼痛的发生率和严重程度方面是有效且安全的。