プロポフォールTCI投与による静脈内鎮静法導入時のリドカインによる血管痛軽減効果 : 0.5%, 1%および2%リドカインの比較

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Pain at the site of intravenous injection of propofol is a common clinical problem. This study was designed to evaluate the efficacy of pretreatment with a different concentration of lidocaine, with or without a tourniquet, to decrease the intensity of injection pain when providing intravenous sedation using 1% Diprivan Injection-Kit (PFS) administered by the Target Controlled Infusion (TCI) method.Methods: 147 female patients undergoing oral day care surgery under local anesthesia with intravenous sedation were randomly assigned to one of 7 groups. No premedication was administered. Patients in group C (n = 21) serving as the control group were pretreated with 0.9% normal saline solution and immediately infused with propofol (PFS) using the TCI mode of a Diprifusor; Patients in group L0.5 (n = 21), L1.0 (n = 21) and L2.0 (n = 21) were pretreated with 0.5%, 1.0% or 2.0% lidocaine (0.5 mg/kg) respectively and immediately infused with propofol (PFS) using the TCI mode of the Diprifusor; Patients in group TL0.5 (n = 21), TL1.0 (n = 21) and TL2.0 (n = 21) were pretreated with 0.5%, 1.0% or 2.0% lidocaine (0.5 mg/kg) respectively along with tourniquet application for 60 seconds followed by propofol (PFS) infusion using the TCI mode of a Diprifusor.Within 20-60 seconds of starting propofol injection, patients were asked to report any discomfort and rate their pain as being absent, mild, moderate or severe. The degree of pain was subsequently scored as: 0: no pain; 1: mild pain; 2: moderate pain; 3: severe pain.Results and Conclusions: There were significant changes in all groups except group L0.5 in the median value of the pain score compared to group C. No significant change of the median value of the pain score was found among groups L0.5, L1.0 and L2.0, and among groups TL0.5, TL1.0 and TL2.0. The median value of the pain score in group TL1.0 was significantly lower than in group L1.0 and the highest incidence of no pain was found in group TL1.0. Consequently, in cases without application of a tourniquet, both 1.0% and 2.0% lidocaine were equally effective for reducing injection pain of propofol, and application of a tourniquet with pretreatment with 0.5%, 1.0% or 2.0% lidocaine is expected to be even more effective in reducing injection pain of propofol. When using 1% lidocaine, it is suggested that applying a tourniquet would produce a significant difference in attenuating injection pain.
2009-08-01

プロポフォールTCI投与による静脈内鎮静法導入時のリドカインによる血管痛軽減効果 : 0.5%, 1%および2%リドカインの比較

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