氯普鲁卡因预罗库溴铵注药痛效果观察.pdfVIP

福建医科大学2006 级同等学力硕士研究生学位论文 氯普鲁卡因预防罗库溴铵注药痛效果观察 摘要:目的 观察应用氯普鲁卡因减轻罗库溴铵注药痛的效果。方法 拟行择期 需行气管内插管全身麻醉患者 150 例，麻醉诱导时用限时法给予肌松药，按麻醉 诱导时给予罗库溴铵前预先静脉注射的药物，将患者随机分为五组，每组30 例。 Ⅰ组生理盐水3ml，Ⅱ组利多卡因30 mg/3ml，Ⅲ组氯普鲁卡因30mg/3ml，Ⅳ组 氯普鲁卡因60mg/3ml，Ⅴ组氯普鲁卡因90mg/3ml。左手背静脉穿刺，置入20G 静脉套管针。为了药物能较长时保留在静脉中，在患者左前臂包裹气压止血带， 加压至70mmHg, 以3ml/10s 的速度在左手背静脉注入各组预先给予的药物，30 s 时松开止血带。随即在 10 s 内注射插管剂量的罗库溴铵0.6 mg /kg，由一名事先 不知用药情况的麻醉医师专职观察且询问患者疼痛情况, 选用Ambesh 四分疼痛 评定法为标准，进行评分、记录。同时观察记录在注射罗库溴铵完毕及术后24h 副作用等情况。结果 I 组罗库溴铵注药痛发生率97%，中度、重度疼痛77%， 轻度疼痛20%；Ⅱ组患者77%无注药痛与Ⅲ组73%相似。3 个氯普鲁卡因处理组 疼痛轻，重度疼痛(0～1/30)，Ⅳ组疼痛更轻，中度、重度疼痛(0/30)；尤其Ⅴ组 100%无注药痛。Ⅱ、Ⅲ、Ⅳ、Ⅴ组与Ⅰ组比较发生罗库溴铵注药痛的程度轻， Ⅴ组罗库溴铵注药痛程度最轻。结论 预注利多卡因、氯普鲁卡因均能减轻罗库 溴铵的注药痛，其中预注氯普鲁卡因90mg 效果最好。 关键词: 氯普鲁卡因；利多卡因；罗库溴铵；注药痛 4 福建医科大学2006 级同等学力硕士研究生学位论文 Effect of Chloroprocaine on pain caused by rocuronium injection Abstract: Objective To explore the effect of chloroprocaine on the pain caused by rocuronium injection. Methods 150 adult patients scheduled for selected surgeries under general anesthesia with a tracheal intubation were randomly assigned to 5 groups (30 per group). The neuromuscular blocking agent was administrated according to timing principle during anesthetic induction period . the dorsum of left hand were catheterized with 20-gauge catheters.With the aim of keeping the drug within the vein,the forearm was squeezed with a tourniquet up to 70 mm Hg; the patients were administered normal saline(3 ml)(GroupⅠ,n =30), lidocaine 30 mg (GroupⅡ,n=30), chloroprocaine 30 mg (GroupⅢ, n =30), chloroprocaine 60 mg (GroupⅣ,n=30),or chloroprocaine 90 mg (GroupⅤ,n=30),diluted into 3 ml of normal saline .The occlusion was released after 30 s and a tracheal intubating dose