• 四川大學(xué)華西醫(yī)院麻醉科（成都，610041）;

目的 　比較預(yù)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?lián)衿谛懈骨荤R下膽囊切除術(shù)的150例患者，按照完全隨機(jī)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(nèi)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(yù)先注射利多卡因及局部加溫緩解注射痛的效果。 結(jié)果 　羅庫溴銨注射痛的發(fā)生率在W組、L組、C組中分別為62%、34%、82%。C組的疼痛發(fā)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(jié)論 　預(yù)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(yù)注射利多卡因?qū)τ诰徑饬_庫溴銨引起的注射痛更為有效。

引用本文： 張晗,劉進(jìn). 預(yù)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(yī)學(xué), 2012, 27(5): 707-710. doi: 復(fù)制

1. 　夏明. 琥珀膽堿與術(shù)后肌痛[J]. 國外醫(yī)學(xué)·麻醉學(xué)與復(fù)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(fù)合利多卡因預(yù)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(xué)[M]. 北京: 人民衛(wèi)生出版社, 2000: 325.
  1. 1. 　夏明. 琥珀膽堿與術(shù)后肌痛[J]. 國外醫(yī)學(xué)·麻醉學(xué)與復(fù)蘇分冊, 2001, 22(6): 326-327.
  2. 2. 　Steegers MAH, Robertson EN. Pain on injection of rocuronium bromide [J]. Anesth Analg, 1996, 83(2): 203.
  3. 3. 　Lockey D, Coleman P. Pain during injection of rocuronium bromide [J]. Anaesthesia, 1995, 50(4): 474.
  4. 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. 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. 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. 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. 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. 9. 　王紅珠, 王軍會, 王惠琴. 昂丹司瓊復(fù)合利多卡因預(yù)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. 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. 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. 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. 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. 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. 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. 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. 17. 　陳伯鑾. 臨床麻醉藥理學(xué)[M]. 北京: 人民衛(wèi)生出版社, 2000: 325.