Pang W W, Mok M S, Huang S, Hwang M H
Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, Republic of China.
Anesth Analg. 1998 Feb;86(2):382-6. doi: 10.1097/00000539-199802000-00031.
Using venous retention with a tourniquet (70 mm Hg), we performed a randomized, double-blind study to assess the efficacy of I.V. pretreatment with fentanyl, morphine, meperidine, or lidocaine in reducing propofol injection pain. Immediately after venous occlusion with a tourniquet, I.V. fentanyl 150 microg (Group A, n = 35), morphine 4 mg (Group B, n = 35), meperidine 40 mg (Group C, n = 35), 2% lidocaine 3 mL (Group D, n = 35), or normal saline 3 mL (Group E, n = 35; as placebo control) was given to adult patients. The venous retention of the drug was maintained for 1 min, followed by tourniquet release and I.V. administration of propofol 100 mg. Pain assessment was made immediately after the propofol injection. Lidocaine and meperidine significantly reduced propofol injection pain more than placebo (P < 0.05), but there were more side effects in the meperidine group. Fentanyl and morphine reduced the intensity of propofol injection pain (P < 0.05) and had some effect in reducing the incidence of propofol injection pain, but the difference did not reach statistical significance. The order of efficacy was lidocaine approximately meperidine > morphine approximately fentanyl. We postulate that the peripheral analgesic effect of these opioid is due to their local anesthetic activity.
Propofol, a commonly used anesthetic, often causes pain on injection. Given as venous retention pretreatments 1 min before propofol, meperidine and lidocaine were found to significantly reduce the propofol injection pain, whereas fentanyl and morphine only slightly reduced the propofol injection pain.
使用止血带进行静脉留置（70毫米汞柱），我们开展了一项随机双盲研究，以评估静脉注射芬太尼、吗啡、哌替啶或利多卡因预处理在减轻丙泊酚注射痛方面的疗效。在使用止血带阻断静脉后，立即给成年患者静脉注射150微克芬太尼（A组，n = 35）、4毫克吗啡（B组，n = 35）、40毫克哌替啶（C组，n = 35）、3毫升2%利多卡因（D组，n = 35）或3毫升生理盐水（E组，n = 35；作为安慰剂对照）。药物静脉留置1分钟，然后松开止血带并静脉注射100毫克丙泊酚。在丙泊酚注射后立即进行疼痛评估。利多卡因和哌替啶比安慰剂更能显著减轻丙泊酚注射痛（P < 0.05），但哌替啶组的副作用更多。芬太尼和吗啡降低了丙泊酚注射痛的强度（P < 0.05），并且在降低丙泊酚注射痛的发生率方面有一定作用，但差异未达到统计学意义。疗效顺序为利多卡因≈哌替啶>吗啡≈芬太尼。我们推测这些阿片类药物的外周镇痛作用归因于它们的局部麻醉活性。
丙泊酚是一种常用麻醉剂，注射时常引起疼痛。在丙泊酚注射前1分钟进行静脉留置预处理时，发现哌替啶和利多卡因能显著减轻丙泊酚注射痛，而芬太尼和吗啡只能轻微减轻丙泊酚注射痛。
