【罂粟摘要】比较静脉注射纳布啡和利多卡因减轻异丙酚在胃镜检查中注射痛的随机对照试验
比较静脉注射纳布啡和利多卡因减轻异丙酚在胃镜检查中注射痛的随机对照试验
异丙酚静脉麻醉广泛应用于无痛内窥镜检查。然而，异丙酚注射痛是一种常见的不良反应。本研究观察了纳布啡和利多卡因减轻异丙酚注射痛的效果。
在这项双盲随机研究中，根据随机数字表法将330例患者分为3组：纳布啡组(N)、利多卡因组(L)和对照组(C)。N、L和C组分别接受0.1 mg/kg纳布啡、0.5 mg/kg利多卡因或等量生理盐水作为预处理药物。然后静脉注射异丙酚。本研究的主要结果是异丙酚诱导一起注射痛的发生率，次要结果包括异丙酚诱导引起注射痛的严重程度、生命体征和不良事件，包括低血压、心动过缓(<50次/分钟)、低氧血症(SpO2<90%)、嗜睡、体动和咳嗽。
C组异丙酚注射痛发生率明显高于N组和L组(分别为64%、34%和27%，P<0.05)。异丙酚注射后剧烈疼痛发生率C组明显高于N组和L组(分别为12%、1%和0%，P<0.05)。C、L组异丙酚用量明显高于N组。N组低氧血症患者明显高于C组和L组。然后，N组体动和咳嗽的患者较少。
0.1 mg/kg纳布啡预处理能有效减轻异丙酚诱导的注射痛和异丙酚用量。异丙酚联合纳布啡用于胃镜检查安全有效。
Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy: A Randomized Controlled Trial
ABSTRACT
Introduction: Intravenous propofol anesthesia is widely used in painless endoscopy. However, propofol injection pain is a common adverse effect. This study investigated the effects of nalbuphine and lidocaine in reducing propofol-induced injection pain.
Methods: In this double-blind, randomized study, 330 patients were randomly divided into three groups by using a random number table: the nalbuphine group (N), lidocaine group (L), and control group (C). The N, L, and C groups received either 0.1 mg/kg nalbuphine, 0.5 mg/ kg lidocaine, or an equivalent volume of normal
saline, respectively, as pretreatment drug. Then propofol was manually injected. The primary outcome of this study was the incidence of propofol-induced injection pain, and secondary outcomes included the severity of propofol-induced injection pain, vital signs, and adverse events, including hypotension, bradycardia (<50 beats/min), hypoxemia (SpO2<90%), drowsiness, physical movement, and cough.
Results: The percentages of patients with propofol injection pain were higher in group C than in group N and group L (64, 34, and 27%, respectively, p < 0.05). The percentage of patients with severe pain after propofol injection was signifificantly higher in group C than in group N and group L (12, 1, and 0%, respectively, p <0.05).The doses of propofol in group C and group L were signifificantly higher than that in group N. More patients suffered hypoxemia in group N than in group C and group L. Then, less patients got physical movement and cough in group N.
Conclusions: Pretreatment with nalbuphine 0.1 mg/kg was effective in reducing propofol-induced injection pain and propofol consumption. Propofol combined with nalbuphine can be safely and effectively used during gastroscopy.
原始文献来源：Jiang Wang . Jinjuan Duan . Cuiyu Xie . Yongqi Yu . Yao Lu.Comparison Between Intravenous Nalbuphine and Lidocaine in Reducing Propofol-Induced Injection Pain During Gastroscopy: A Randomized
Controlled Trial.Pain Ther 2020 Dec;9(2):563-571. doi:10.1007/s40122-020-00188-y.
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翻译：任文鑫
编辑：佟睿
审校：曹莹