摘要
目的进行上肢不同部位在丙泊酚静脉注射时疼痛的比较性研究与预防。方法选择ASA分级Ⅰ～Ⅱ级447例,在丙泊酚全凭静脉麻醉下实施上消化道内镜诊疗,将患者随机分为肘正中静脉组(EI组)、桡静脉组(RI组)及手背静脉组(HI组),每组149例。EI组在无痛上消化道内窥镜诊疗下于肘正中静脉缓慢匀速注射丙泊酚注射液;采用同样方法对RI组与HI组注射,除常规连续监测收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)外,采用疼痛视觉模拟评分(VAS),三组除记录麻醉药物用量和辅助用药情况,均需连续监测患者呼吸、血流动力学变化以及不良反应等内容。结果丙泊酚推注可使局部出现刺激性胀痛与放射性疼痛,HI组与RI组较EI组疼痛明显,三组VAS评分比较差异有高度统计学意义(P<0.01),EI组局部疼痛减轻,但放射痛仍然存在。实施护理干预、缓慢诱导、匀速注射及复合利多卡因等预防注射痛效果明显。结论上肢不同部位丙泊酚静脉注射痛比较显示,肘正中静脉、桡静脉与手背静脉疼痛依次递增,采取复合利多卡因的方法则能有效预防。
Objective To observe the upper limbs in different parts of the propofol injection pain research and prevention. Methods 447 patients of ASA physical status I - II were selected, who were given the diagnosis and treatment of upper gastrointestinal endoscopy under Propofol total intravenous anesthesia, and randomly divided into the median cubital vein group （EI group）, the radial vein group （RI group） and the dorsal hand veingroup （HI group）, each group had 149 cases. EI group was given Propofol injection in median cubital vein with the diagnosis and treatment of painless digestive tract en- doscopy; the same way as RI group and HI group were injected, in addition to the conventional continuous monitoring of SBP, DBP, HR, SpOz, the pain visual analogue scale （VAS） was used, unless the record of the narcotic drug dosage and adjuvant need to be record, patient respiration, hemodynamic changes and adverse reactions continuous were also moni- tored. Results Propofol could make skin appeared local irritating pain and radiating pain, the pain of HI group was obvious compared with the RI group than the E1 group, which VAS score had significant difference （P 〈 0.01）, the local pain of El group released, but radiating pain still existed. Nursing intervention, slow induction, uniform injection and Lidocaine for prevent injection had a obvious effect. Conclusion Comparison of pain on injection by Propofol in the different parts of the upper limb shows that the median eubital vein, radial vein and dorsal hand vein pain in ascending order, taking Lidocaine is effective in preventing.
出处
《中国医药导报》
CAS
2012年第23期166-168,共3页
China Medical Herald
基金
河南中医学院第一附属医院科研基金项目(课题编号:2011KJ28)
关键词
丙泊酚注射液
上消化道内窥镜诊疗
上肢
注射痛
护理干预
Propofol Injection
Upper gastrointestinal endoscopy clinics
Upper limbs
Pain on injection
Nursing inter- vention
