Jung Jaehak, Kim Byoungryun, Park Seong Nam, Lee Jiheui, Choi Insung, Lee Myeong Jong, Yim Hyeonbin, Lee Cheol, Lee JuHwan
Department of Obstetrics & Gynecology, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan, Jeonllabuk-do 54538, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Korea Cancer Center Hospital, 75 Nowon-ro, Nowon-gu, Seoul 01812, Republic of Korea.
Pain Res Manag. 2020 Dec 9;2020:6642460. doi: 10.1155/2020/6642460. eCollection 2020.
Temporal summation of pain, which is defined as the perception of greater pain evoked by repetitive painful stimuli, varies among individuals. This study aimed at determining the impact of the timing of rocuronium after induction with propofol on the temporal summation of pain.
One hundred patients aged 19-60 years underwent gynecologic laparoscopic surgery. Patients were randomly assigned to one of the two groups: group PRi received immediate injections of rocuronium after propofol administration and group PRd received rocuronium injections when the bispectral index score (BIS) decreased to <60 after propofol administration. The grade of rocuronium-induced withdrawal movement (RIWM) according to the timing of propofol injection, the incidence and severity of propofol injection pain (PIP), rescue analgesics, visual analog scale (VAS) score after surgery for postoperative pain, patient-controlled analgesia (PCA) opioid consumption, association between PIP and the grade of RIWM, and associations between PIP, the grade of RIWM, and postoperative pain outcomes were measured.
The differences between the incidence and severity of PIP in the two groups were not significant. The grade of the RIWM in the PRd group was significantly reduced compared with the PRi group. Rescue analgesics, severity for postoperative pain, and PCA opioid consumption were not significant. Correlations between the incidence and severity of PIP and the grade of RIWM were weakly negative. Correlations between the grade of RIWM and pain outcomes were moderately positive, but correlations between the severity for PIP and the postoperative pain outcomes were negligible.
The timing of rocuronium administration after propofol injection played a role in reducing RIWM. The grade of RIWM was significantly related to pain outcomes compared with the severity of PIP. Therefore, delayed rocuronium injection after induction with propofol reduced temporal summation of pain.
疼痛的时间总和被定义为重复性疼痛刺激诱发的更强烈疼痛感知，个体之间存在差异。本研究旨在确定异丙酚诱导后罗库溴铵给药时间对疼痛时间总和的影响。
100例年龄在19至60岁之间的患者接受妇科腹腔镜手术。患者被随机分为两组之一：PRi组在给予异丙酚后立即注射罗库溴铵，PRd组在给予异丙酚后双谱指数（BIS）降至<60时注射罗库溴铵。根据异丙酚注射时间评估罗库溴铵诱发的退缩运动（RIWM）分级、异丙酚注射痛（PIP）的发生率和严重程度、解救镇痛药、术后疼痛视觉模拟量表（VAS）评分、患者自控镇痛（PCA）阿片类药物消耗量、PIP与RIWM分级之间的关联，以及PIP、RIWM分级与术后疼痛结局之间的关联。
两组PIP的发生率和严重程度差异无统计学意义。与PRi组相比，PRd组的RIWM分级显著降低。解救镇痛药、术后疼痛严重程度和PCA阿片类药物消耗量差异无统计学意义。PIP的发生率和严重程度与RIWM分级之间的相关性呈弱负相关。RIWM分级与疼痛结局之间的相关性呈中度正相关，但PIP严重程度与术后疼痛结局之间的相关性可忽略不计。
异丙酚注射后罗库溴铵的给药时间在降低RIWM方面起作用。与PIP严重程度相比，RIWM分级与疼痛结局显著相关。因此，异丙酚诱导后延迟注射罗库溴铵可减少疼痛的时间总和。
