甲氧氯普胺预处理预防丙泊酚注射液疼痛的随机安慰剂对照研究

Muhammad Sazzad Hossain, S. Islam, Afzalur Rahman, M. Alamgir, Waliullah
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摘要

背景:异丙酚是最常用的静脉麻醉剂,用于常规选择性手术患者的诱导、维持麻醉和镇静。丙泊酚注射后的疼痛仍然是麻醉师非常关心的问题。目的:观察甲氧氯普胺预处理对全麻下择期手术患者丙泊酚注射镇痛的效果。材料和方法:共有80名患者参加了这项研究,年龄组为20至50岁,无论性别,ASA等级为I/II,计划在全麻下进行常规选择性手术,气管插管,并使用丙泊酚作为诱导剂。入选的患者被随机分为两组,每组40名患者。A组接受在5毫升生理盐水中稀释的10毫克甲氧氯普胺静脉注射。B组在丙泊酚注射前给予生理盐水5ml作为安慰剂。患者被要求根据提供给他们的疼痛程度报告,包括注射丙泊酚后的无疼痛、轻度疼痛、中度疼痛和重度疼痛。结果:A组(甲氧氯普胺组)的总疼痛发生率和严重程度显著低于B组(安慰剂组)(p<0.05)。A组与B组的轻度和中度疼痛发生率分别为15%与45%和5%与25%(p<0.05),A组的0分(无疼痛)发生率(80%)高于B组(25%)(p<0.05)甲氧氯普胺能有效缓解丙泊酚注射后的疼痛,无明显副作用。
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Metoclopramide Pretreatment for Prevention of Pain on Propofol Injection: A Randomized Placebo-Controlled Study
Background: Propofol, the most frequently used intravenous anaesthetic, is used for induction, maintenance of anaesthesia and for sedation in patients scheduled for routine elective surgical procedure. Pain on propofol injection still remains a considerable concern for the anaesthesiologist. Objective: Aim of this study was to observe the efficacy of metoclopramide as pretreatment for the prevention of pain caused by the propofol injection in patients undergoing elective surgery under general anaesthesia. Materials and method: A total of 80 patients were taken up in the study in the age group of 20 to 50 years of either sex, ASA grade I/II, scheduled for routine elective surgical procedure under general anesthesia with endotracheal intubation and using propofol as induction agent. The patients enrolled were divided randomly into two groups of 40 patients each. Group A received 10 mg metoclopramide IV diluted in 5 ml saline. Group B received 5 ml of normal saline as placebo before propofol injection. The patients were asked to report their pain according to the scale provided to them in the form of none, mild, moderate and severe after injection of propofol. Results: The overall incidence and severity of pain were significantly less in Group A (metoclopramide group) than in group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 15% vs 45% and 5% vs 25% respectively (p<0.05). The incidence of score ‘0’ (no pain) was higher in Group A (80%) thanGroup B (25%) (p< 0.05). Conclusion: Intravenous metoclopramide is effective for relief of pain on propofol injection without any significant side effects.
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