硫酸镁与昂丹斯琼对2%异丙酚注射痛的影响
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摘要
目的:观察硫酸镁与昂丹斯琼对2%异丙酚注射痛的影响。方法:选取90例择期在全身麻醉下行腹腔镜胆囊切除术患者随机分为三组,硫酸镁组:150 mg硫酸镁,3 ml;昂丹斯琼组:4 mg昂丹斯琼,3 ml;对照组:0.9%生理盐水3 ml。主要观察记录异丙酚推注开始5 s(T_5)、10 s(T_(10))、20 s(T_(20))、25 s(T_(25))患者异丙酚注射处疼痛情况。结果:三组患者插管前基础值、诱导后3 min、插管后即刻、插管后5 min后平均动脉压、心率比较,差异无统计学意义(P>0.05);与对照组比较,硫酸镁组和昂丹斯琼组无注射痛的患者少于对照组,差异有统计学意义(P<0.05),而硫酸镁组和昂丹斯琼组之间,无注射痛患者差异无统计学意义(P>0.05)。开始推注异丙酚10 s、25 s时,重度疼痛患者对照组多于硫酸镁组和昂丹斯琼组,差异有统计学意义(P<0.05);硫酸镁组和昂丹斯琼组之间,重度疼痛患者差异无统计学意义(P>0.05)。结论:与生理盐水相比,硫酸镁或者昂丹斯琼能减少2%异丙酚注射痛,两种药物的镇痛作用无差异。并且,硫酸镁或昂丹斯琼并未对麻醉诱导血流动力学产生影响。
Objective This clinical trial compares analgesic effect of ondansetron,magnesium sulphate and placebo on patients after propofol 2% injection.Method 90 patients undergoing general anesthesia with laparoscopic cholecystectomy were randomly allocated into three groups with 30 patients each:magnesium sulfate group:3 ml:150 mg magnesium sulfate, ondansetron group:3 ml:4 mg ondansetron, control group:3 ml:0.9% normal saline.Pain intensity of propofol injection in subjects was assessed by a four-point scale at four time intervals(5,10,20 and 25 s) after injection.Results There was no significant difference in mean arterial pressure and heart rate between the 3 groups before intubation,3 min after induction,immediately after intubation,after intubation and after intubation(P>0.05).Compared with control group,magnesium sulfate group and ondansetron group had significant impacts on pain reduction after propofol 2% injection(P<0.05).Comparing two trial groups did not have any significant priority for analgesic impact(P>0.05).When propofol was started for 10 and 25 seconds,patients with severe pain in control group were more than magnesium sulfate group and ondansetron group(P<0.05),and there was no statistical difference between magnesium sulfate group and ondansetron group(P>0.05).Both ondansetron and MS had no effect on the MAP and HR.Conclusion Compared with normal saline,magnesium sulfate and ondansetron can reduce the injection pain of propofol 2%,and there is no difference in analgesic effect between the two drugs.Moreover,magnesium sulfate and ondansetron did not affect hemodynamics induced by anesthesia induction.
Objective This clinical trial compares analgesic effect of ondansetron,magnesium sulphate and placebo on patients after propofol 2% injection.Method 90 patients undergoing general anesthesia with laparoscopic cholecystectomy were randomly allocated into three groups with 30 patients each:magnesium sulfate group:3 ml:150 mg magnesium sulfate, ondansetron group:3 ml:4 mg ondansetron, control group:3 ml:0.9% normal saline.Pain intensity of propofol injection in subjects was assessed by a four-point scale at four time intervals(5,10,20 and 25 s) after injection.Results There was no significant difference in mean arterial pressure and heart rate between the 3 groups before intubation,3 min after induction,immediately after intubation,after intubation and after intubation(P>0.05).Compared with control group,magnesium sulfate group and ondansetron group had significant impacts on pain reduction after propofol 2% injection(P<0.05).Comparing two trial groups did not have any significant priority for analgesic impact(P>0.05).When propofol was started for 10 and 25 seconds,patients with severe pain in control group were more than magnesium sulfate group and ondansetron group(P<0.05),and there was no statistical difference between magnesium sulfate group and ondansetron group(P>0.05).Both ondansetron and MS had no effect on the MAP and HR.Conclusion Compared with normal saline,magnesium sulfate and ondansetron can reduce the injection pain of propofol 2%,and there is no difference in analgesic effect between the two drugs.Moreover,magnesium sulfate and ondansetron did not affect hemodynamics induced by anesthesia induction.
引文
[1] Picard P,Tramèr MR.Prevention of pain on injection with propofol:A quantitative systematic review[J].Anesth Analg,2000,90(4):963.
[2] Macario A,Weinger M,Truong P,et al.Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists[J].Anesth Analg ,1999,88(5):1085.
[3] Bachmann-Mennenga B,Ohlmer A,Boedeker RH,et al.Preventing pain during injection of propofol:Effects of a new emulsion with lidocaine addition[J].Eur J Anaesthesiol,2007,24(1):33.
[4] Shenglin Pei,Chengmao Zhou,Yu Zhou,et al.Ondansetron can effectively prevent propofol injection pain,and the effect is similar to that of magnesium sulfate and lidocaine[J].J Pain Res,2017,10:445.
[5] Memis D,Turan A,Karamanlioglu B,et al.The prevention of propofol injection pain by tramadol or ondansetron[J].Eur J Anaesthesiol,2002,19(1):47.
[6] Draskovic B,Knezevic S,Radovanovic D,et al. Ondansetron,alfentanil and nitrous oxide in the prevention of pain on injection of propofol[J].Srp Arh Celok Lek,2013,141(1-2):61.
[7] Klement W,Arndt JO.Pain on injection of propofol:Effects of concentration and diluent[J].Br J Anaesth,1991,67(3):281.
[8] Ambesh SP,Dubey PK,Sinha PK.Ondansetron pretreatment to alleviate pain on propofol injection:A randomized,controlled,double-blinded study[J].Anesth Analg,1999,89(1):197.
[9] Scott RP,Saunders DA,Norman J.Propofol:Clinical strategies for preventing the pain of injection[J].Anaesthesia,1988,43(6):492.
[10] Lee EH,Lee SH,Park DY,et al.Physicochemical properties,pharmacokinetics,and pharmacodynamics of a reformulated microemulsion propofol in rats[J].Anesthesiology,2008,109(3):436.
[11] Zhang H,Wickley PJ,Sinha S,et al.Propofol restores transient receptor potential vanilloid receptor subtype-1 sensitivity via activation of transient receptor potential ankyrin receptor subtype-1 in sensory neurons[J].Anesthesiology,2011,114(5):1169.
[12] 姜慧芳,方军,连燕虹.小剂量艾司洛尔对丙泊酚注射痛的缓解作用[J].临床麻醉学杂志,2014,30(7):676.
[13] Roczniak W,Wróbel J,Dolczak L,et al.Influence of Central noradrenergic system lesion on the serotoninergic 5-HT3 receptor mediated analgesia in rats[J].Adv Clin Exp Med,2013,22(5):629.
[14] Shenglin Pei,Chengmao Zhou,Yu Zhu,et al.Efficacy of ondansetron for the prevention of propofol injection pain:a meta-analysis[J].J Pain Res,2017,10:445.
[15] Lee SK.Pain on injection with propofol[J].Korean J Anesthesiol,2010,59(4):297.
[2] Macario A,Weinger M,Truong P,et al.Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists[J].Anesth Analg ,1999,88(5):1085.
[3] Bachmann-Mennenga B,Ohlmer A,Boedeker RH,et al.Preventing pain during injection of propofol:Effects of a new emulsion with lidocaine addition[J].Eur J Anaesthesiol,2007,24(1):33.
[4] Shenglin Pei,Chengmao Zhou,Yu Zhou,et al.Ondansetron can effectively prevent propofol injection pain,and the effect is similar to that of magnesium sulfate and lidocaine[J].J Pain Res,2017,10:445.
[5] Memis D,Turan A,Karamanlioglu B,et al.The prevention of propofol injection pain by tramadol or ondansetron[J].Eur J Anaesthesiol,2002,19(1):47.
[6] Draskovic B,Knezevic S,Radovanovic D,et al. Ondansetron,alfentanil and nitrous oxide in the prevention of pain on injection of propofol[J].Srp Arh Celok Lek,2013,141(1-2):61.
[7] Klement W,Arndt JO.Pain on injection of propofol:Effects of concentration and diluent[J].Br J Anaesth,1991,67(3):281.
[8] Ambesh SP,Dubey PK,Sinha PK.Ondansetron pretreatment to alleviate pain on propofol injection:A randomized,controlled,double-blinded study[J].Anesth Analg,1999,89(1):197.
[9] Scott RP,Saunders DA,Norman J.Propofol:Clinical strategies for preventing the pain of injection[J].Anaesthesia,1988,43(6):492.
[10] Lee EH,Lee SH,Park DY,et al.Physicochemical properties,pharmacokinetics,and pharmacodynamics of a reformulated microemulsion propofol in rats[J].Anesthesiology,2008,109(3):436.
[11] Zhang H,Wickley PJ,Sinha S,et al.Propofol restores transient receptor potential vanilloid receptor subtype-1 sensitivity via activation of transient receptor potential ankyrin receptor subtype-1 in sensory neurons[J].Anesthesiology,2011,114(5):1169.
[12] 姜慧芳,方军,连燕虹.小剂量艾司洛尔对丙泊酚注射痛的缓解作用[J].临床麻醉学杂志,2014,30(7):676.
[13] Roczniak W,Wróbel J,Dolczak L,et al.Influence of Central noradrenergic system lesion on the serotoninergic 5-HT3 receptor mediated analgesia in rats[J].Adv Clin Exp Med,2013,22(5):629.
[14] Shenglin Pei,Chengmao Zhou,Yu Zhu,et al.Efficacy of ondansetron for the prevention of propofol injection pain:a meta-analysis[J].J Pain Res,2017,10:445.
[15] Lee SK.Pain on injection with propofol[J].Korean J Anesthesiol,2010,59(4):297.