O'Hara J R, Sprung J, Laseter J T, Maurer W G, Carpenter T, Beven M, Mascha E
Department of General Anesthesiology, Cleveland Clinic Foundation, Ohio 44195, USA.
Anesth Analg. 1997 Apr;84(4):865-9. doi: 10.1097/00000539-199704000-00030.
We performed a randomized, placebo-controlled, double-blind study to compare the efficacy of intravenous (I.V.) lidocaine and topical nitroglycerin ointment in preventing pain during propofol injection. Nitroglycerin or placebo ointments were applied to the back of the hand over the skin area overlying the I.V. catheter tip; lidocaine was or was not added to the propofol solution. One hundred twenty-four patients were randomly assigned to receive one of four treatments: placebo and plain propofol, propofol mixed with lidocaine, nitroglycerin ointment and plain propofol, and nitroglycerin ointment and propofol mixed with lidocaine. Hence, there were 31 patients in each treatment group. Patients receiving nitroglycerin ointment and plain propofol had the highest incidence of pain on propofol injection (23 of 31 patients, 74%), and the highest median pain score. Only when lidocaine was added to propofol did it effectively reduce the incidence and severity of pain. Patients aged 50 yr and older had a significantly lower incidence and less severe pain. We conclude that lidocaine and age, but not topical nitroglycerin ointment, are factors associated with a decreased incidence of propofol-induced pain.
我们进行了一项随机、安慰剂对照、双盲研究，以比较静脉注射利多卡因和局部应用硝酸甘油软膏在预防丙泊酚注射时疼痛方面的疗效。将硝酸甘油或安慰剂软膏涂于手背覆盖静脉导管尖端的皮肤区域；在丙泊酚溶液中添加或不添加利多卡因。124例患者被随机分配接受四种治疗之一：安慰剂和普通丙泊酚、丙泊酚与利多卡因混合、硝酸甘油软膏和普通丙泊酚、硝酸甘油软膏和丙泊酚与利多卡因混合。因此，每个治疗组有31例患者。接受硝酸甘油软膏和普通丙泊酚的患者在丙泊酚注射时疼痛发生率最高（31例患者中有23例，74%），且疼痛中位数评分最高。只有在丙泊酚中添加利多卡因时，才能有效降低疼痛的发生率和严重程度。50岁及以上的患者疼痛发生率显著较低，疼痛程度也较轻。我们得出结论，利多卡因和年龄而非局部应用硝酸甘油软膏是与丙泊酚诱导疼痛发生率降低相关的因素。
