Borgeat A, Wilder-Smith O H, Mentha G
Department of Anesthesiology and Digestive Surgery, University Hospital of Geneva, Switzerland.
Gastroenterology. 1993 Jan;104(1):244-7. doi: 10.1016/0016-5085(93)90858-a.
Pruritus is a severe and troublesome symptom in patients with cholestasis and is often difficult to treat. Propofol was recently shown to be efficient in relieving pruritus secondary to spinal morphine administration. The efficacy of propofol was therefore investigated in patients with pruritus associated with liver disease.
In a prospective, randomized, double-blind, crossover, placebo-controlled study, 10 patients received 2 doses of propofol (1.5 mL = 15 mg) and 2 doses of placebo (1.5 mL of Intralipid, Kabi-Pharm., Helsinki, Finland) during a 4-day study period. Pruritus was assessed by a verbal rating score from 0 (no pruritus) to 10 (most severe pruritus imaginable). Treatment success was defined as a decrease of pruritus of at least 4 points in the verbal rating score.
Treatment success was achieved in 85% of the patients receiving propofol and in 10% of those receiving Intralipid (P < 0.01). Discomfort on injection (15%) and slight dizziness (10%) were observed with propofol treatment.
This study shows that subhypnotic doses of propofol are effective for the short-term symptomatic relief of pruritus associated with liver disease. At the dose used, side effects were rare and minor.
瘙痒是胆汁淤积患者严重且困扰的症状，通常难以治疗。最近有研究表明丙泊酚可有效缓解脊髓注射吗啡所致的瘙痒。因此，本研究探讨丙泊酚对肝病相关瘙痒患者的疗效。
在一项前瞻性、随机、双盲、交叉、安慰剂对照研究中，10例患者在为期4天的研究期间接受2剂丙泊酚（1.5 mL = 15 mg）和2剂安慰剂（1.5 mL英脱利匹特，芬兰赫尔辛基卡比药业）。瘙痒程度采用言语评分法评估，从0分（无瘙痒）至10分（可想象的最严重瘙痒）。治疗成功定义为言语评分法中瘙痒程度至少降低4分。
接受丙泊酚治疗的患者中85%治疗成功，接受英脱利匹特治疗的患者中10%治疗成功（P < 0.01）。丙泊酚治疗时观察到注射部位不适（15%）和轻微头晕（10%）。
本研究表明，亚催眠剂量的丙泊酚可有效缓解肝病相关瘙痒的短期症状。在所使用的剂量下，副作用罕见且轻微。
