預注射利多卡因與局部加溫緩解羅庫溴銨注射痛的比較_《華西醫學》

作者：

張晗 ,  劉進

四川大學華西醫院麻醉科（成都，610041）;

關鍵詞：

羅庫溴銨注射痛利多卡因局部加溫止血帶

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目的　比較預注射利多卡因和局部加溫緩解羅庫溴銨注射痛效果。方法　選取2011年3月－8月擇期行腹腔鏡下膽囊切除術的150例患者，按照完全隨機的方法分為利多卡因組（L組）、局部加溫組（W組）、對照組（C組）,每組各50例患者。W組患者在留置針部位用Bair Hugger以40 °C加溫1 min；L組患者用橡膠止血帶在靜脈近端加壓直至靜脈輸液停止走行，推注1%利多卡因2 mL，1 min后松開止血帶。隨后3組患者均在2 s內靜脈推注1 mL羅庫溴銨注射液（含羅庫溴銨10 mg）。觀察在注射羅庫溴銨前預先注射利多卡因及局部加溫緩解注射痛的效果。結果　羅庫溴銨注射痛的發生率在W組、L組、C組中分別為62%、34%、82%。C組的疼痛發生率最高（P＜0.05）；W組的疼痛率高于L組（P＜0.05）；與W、L組相比，C組的重度疼痛率最高（P＜0.05）；L組的中、重度疼痛率低于W組（P＜0.05）。結論　預注射利多卡因和局部加溫均能有效緩解羅庫溴銨引起的注射痛，預注射利多卡因對于緩解羅庫溴銨引起的注射痛更為有效。

引用本文： 張晗,劉進. 預注射利多卡因與局部加溫緩解羅庫溴銨注射痛的比較. 華西醫學, 2012, 27(5): 707-710. doi: 復制

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2.	Steegers MAH, Robertson EN. Pain on injection of rocuronium bromide [J]. Anesth Analg, 1996, 83(2): 203.
3.	Lockey D, Coleman P. Pain during injection of rocuronium bromide [J]. Anaesthesia, 1995, 50(4): 474.
4.	Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? [J]. Br J Anaesth, 1997, 79(3): 382-383.
5.	Mahajan C, Rath GP, Bithal PK, et al. Local warming at injection site helps alleviate pain after rocuronium administration[J]. J Anesth, 2010, 24(6): 845-848.
6.	Liou JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration [J]. Chang Gung Med J, 2002, 25(9): 617-620.
7.	Turan A, Memis D, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by magnesium sulphate，lignocaine, sodium bicarbonate and alfentanil[J]. Anaesth Intensive Care, 2003, 31(3): 277-281．.
8.	Chiarella AB, Jolly DT, Huston CM, et al. Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium[J]. Br J Anaesth, 2003, 90(3) : 377- 379.
9.	王紅珠, 王軍會, 王惠琴. 昂丹司瓊復合利多卡因預防羅庫溴銨注射痛臨床分析[J]. 中國藥物與臨床, 2010, 10(12): 1410-1411.
10.	Klement W, Arndt JO. Pain on intravenous injection of some anesthetic agents is evoked by the unphysiological osmolality or pH of their formulations[J]. Br J Anaesth, 1991, 66(2): 189-195.
11.	Baek SH, Woo CM, Lee HJ, et al. Rocuronium induced with drawal movements associated with different rocuronium injection method[J]. Paediatric Anaesth, 2008, 18(6): 515-519.
12.	Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment[J]. Br J Anaesth, 2000, 84 (1): 106-107.
13.	Kim SK, Kwon MA, Park JS. The amount of 8.4% sodium bicarbonate needed to neutralize the acidity of rocuronium so as to prevent injection pain [J]. J Clin Anesth, 2009, 20(8): 629-630.
14.	Blunk JA, Seifert F, Schmelz M, et al. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings[J]. Eur J Anaesthesiol, 2003, 20(3): 245-253.
15.	Memis D, Turan A, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol and fentanyl[J]. Anesth Analg, 2002, 94(6): 1517-1520.
16.	Fujii Y, Shiga Y. Influence of aging on lidocaine requirements for pain on injection of propofol[J]. J Clin Anesth, 2006, 18 (7): 526-529.
17.	陳伯鑾. 臨床麻醉藥理學[M]. 北京: 人民衛生出版社, 2000: 325.

1. 　夏明. 琥珀膽堿與術后肌痛[J]. 國外醫學·麻醉學與復蘇分冊, 2001, 22(6): 326-327.
2. 　Steegers MAH, Robertson EN. Pain on injection of rocuronium bromide [J]. Anesth Analg, 1996, 83(2): 203.
3. 　Lockey D, Coleman P. Pain during injection of rocuronium bromide [J]. Anaesthesia, 1995, 50(4): 474.
4. 　Borgeat A, Kwiatkowski D. Spontaneous movements associated with rocuronium: is pain on injection the cause? [J]. Br J Anaesth, 1997, 79(3): 382-383.
5. 　Mahajan C, Rath GP, Bithal PK, et al. Local warming at injection site helps alleviate pain after rocuronium administration[J]. J Anesth, 2010, 24(6): 845-848.
6. 　Liou JT, Huang SJ, Yang CY, et al. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration [J]. Chang Gung Med J, 2002, 25(9): 617-620.
7. 　Turan A, Memis D, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by magnesium sulphate，lignocaine, sodium bicarbonate and alfentanil[J]. Anaesth Intensive Care, 2003, 31(3): 277-281．.
8. 　Chiarella AB, Jolly DT, Huston CM, et al. Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium[J]. Br J Anaesth, 2003, 90(3) : 377- 379.
9. 　王紅珠, 王軍會, 王惠琴. 昂丹司瓊復合利多卡因預防羅庫溴銨注射痛臨床分析[J]. 中國藥物與臨床, 2010, 10(12): 1410-1411.
10. 　Klement W, Arndt JO. Pain on intravenous injection of some anesthetic agents is evoked by the unphysiological osmolality or pH of their formulations[J]. Br J Anaesth, 1991, 66(2): 189-195.
11. 　Baek SH, Woo CM, Lee HJ, et al. Rocuronium induced with drawal movements associated with different rocuronium injection method[J]. Paediatric Anaesth, 2008, 18(6): 515-519.
12. 　Cheong KF, Wong WH. Pain on injection of rocuronium: influence of two doses of lidocaine pretreatment[J]. Br J Anaesth, 2000, 84 (1): 106-107.
13. 　Kim SK, Kwon MA, Park JS. The amount of 8.4% sodium bicarbonate needed to neutralize the acidity of rocuronium so as to prevent injection pain [J]. J Clin Anesth, 2009, 20(8): 629-630.
14. 　Blunk JA, Seifert F, Schmelz M, et al. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings[J]. Eur J Anaesthesiol, 2003, 20(3): 245-253.
15. 　Memis D, Turan A, Karamanlioglu B, et al. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol and fentanyl[J]. Anesth Analg, 2002, 94(6): 1517-1520.
16. 　Fujii Y, Shiga Y. Influence of aging on lidocaine requirements for pain on injection of propofol[J]. J Clin Anesth, 2006, 18 (7): 526-529.
17. 　陳伯鑾. 臨床麻醉藥理學[M]. 北京: 人民衛生出版社, 2000: 325.

《華西醫學》

預注射利多卡因與局部加溫緩解羅庫溴銨注射痛的比較

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《華西醫學》

預注射利多卡因與局部加溫緩解羅庫溴銨注射痛的比較

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